Marotta Angela, Fiorio Mirta, Fracasso Isabella, Franchini Carlo Andrea, Defazio Giovanni, Tinazzi Michele
Department of Neurosciences, Biomedicine and Movement Sciences, Università di Verona, Verona, Italy.
Italian Society of General Practice and Primary Care (SIMG)-Section of Verona, Verona, Italy.
Front Neurol. 2021 Jan 25;12:583672. doi: 10.3389/fneur.2021.583672. eCollection 2021.
General practitioners (GPs) provide primary care and advise their patients on which diagnostic and therapeutic pathways they judge most appropriate. For patients with functional neurological disorders (FND), receiving a proper explanation of diagnosis by their GP from the very beginning may drastically improve prognosis. Novel approaches to the diagnosis and treatment of FND have important implications for effective management. The aim of this study was to investigate Italian GP opinion and knowledge about FND in light of new approaches to the illness. To do this, we evaluated the responses to a 13-item web-based survey completed by 133 GPs practicing in northern Italy. Psychological terms to describe FND were more frequently used than functional neurological disorder and mental illness was considered an important predictor of diagnosis. Referral to a neurologist rather than to a psychiatrist was largely preferred, while physiotherapy consultation was seldom recognized as a valuable approach to treating FND. Overall, the survey findings suggest that knowledge about novel approaches to FND is somewhat lacking. Currently, GPs appear to be transitioning from a classical psychological view of the disorder toward a more modern conceptualization, in which neurobiological, psychological, and social factors all play an important role. Professional education during this transition would be an advantageous way to optimize physician management of FND and to enhance diagnosis, explanation, and management across primary and secondary care pathways.
全科医生提供初级保健服务，并就他们认为最合适的诊断和治疗途径向患者提供建议。对于患有功能性神经障碍（FND）的患者，从一开始就得到全科医生对诊断的恰当解释可能会显著改善预后。FND诊断和治疗的新方法对有效管理具有重要意义。本研究的目的是根据该疾病的新方法，调查意大利全科医生对FND的看法和了解。为此，我们评估了在意大利北部执业的133名全科医生对一项基于网络的13项调查问卷的回答。描述FND时，心理学术语的使用频率高于功能性神经障碍，且精神疾病被认为是诊断的重要预测因素。大多数人更倾向于将患者转诊给神经科医生而非精神科医生，而物理治疗咨询很少被视为治疗FND的有效方法。总体而言，调查结果表明，对FND新方法的了解有所欠缺。目前，全科医生似乎正在从对该疾病的传统心理学观点转向更现代的概念化，即神经生物学、心理学和社会因素都发挥着重要作用。在这一转变过程中的专业教育将是优化医生对FND的管理，并加强初级和二级保健途径中的诊断、解释和管理的有利方式。
