Given the high prevalence of FND and the need to promote integrated care models for this patient population, one article describes insights gained from established subspecialty FND clinics in the United Kingdom, Switzerland, and Canada ( 15). Toward that end, the international FND Core Outcome Measures group-the first large-scale international collaboration in the field, comprising 40 members from 14 countries and including patient group representation-discusses the complexities of standardizing outcomes for FND and outlines a research agenda to optimize outcome measurement ( 14). A necessary prerequisite to evidence-based treatments and effective clinical services is the development of a core battery of accepted and widely used outcome measures. Reflecting increasing clinical and research interest in FND as well as the need for a larger repertoire of evidenced-based therapeutics, several articles present new findings on the treatment of FND. Additionally, another article integrates psychological and neurobiological models in the service of bridging the gap between the historical conversion model and modern systems-level neuroscience insights into FND ( 13). A new questionnaire for the concurrent assessment of adverse life events, negative emotions, and attachment styles among individuals with FND across the lifespan is also introduced ( 12). Other articles identify predisposing vulnerabilities and perpetuating factors for FND ( 8) and characterize roles for locus of control (frame of reference) ( 9), impaired action inhibition ( 10), and altered emotional reactivity ( 11) among persons with FND. Several articles advance our understanding of the phenomenology of FND, including the development of a conceptual model for acute functional paralysis ( 6) (a common stroke mimic) and the intersection of Parkinson’s disease and functional movement disorders ( 7). Importantly, the neuropsychiatric perspective that incorporates biopsychosocial aspects at the individual level, including consideration of community and spiritual aspects when relevant ( 3), is key for treatment and research for this complex condition.įor this special issue of the Journal, an international group of guest coeditors and authors organized to detail the depth and breadth of advancement in the field of FND, while also identifying areas of need. A figurative conceptualization of this interdisciplinary approach to FND, as discussed in this special issue of the Journal, is featured on the cover of this issue.įND is among the most common conditions encountered by neurologists and neuropsychiatrists today ( 4) and is often misidentified as “medical mysteries” in human interest stories ( 5). Furthermore, FND challenges the artificial divide between physical and mental health and can benefit greatly from an interdisciplinary approach across the clinical neurosciences ( 2, 3). As such, FND is a core neuropsychiatric disorder that exists at the intersection of the mind and brain. Hales ( 1)įunctional neurological disorder (FND), also known as conversion disorder, constitutes individuals with neurological symptoms precipitated and/or perpetuated by maladaptive cognitive, affective, behavioral, psychological, and perceptual processes. Foundational to any definition of neuropsychiatry is the indelible inseparability of brain and thought, of mind and body, and of mental and physical.
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