Department of Psychiatry, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
Department of Consultation-Liaison Psychiatry, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
J Neurol. 2021 Dec;268(12):4882-4889. doi: 10.1007/s00415-021-10797-y. Epub 2021 Sep 19.
Functional Neurological Disorder (FND) is a complex neuropsychiatric condition with a multifactorial aetiology. The heterogeneity of patients with FND is rarely considered in psychotherapy trials, which may contribute to variable outcomes. Shared Individual Formulation Therapy (SIFT) is a new, brief (four session) psychotherapy that aims to accommodate heterogeneity by providing a personalised, trans-theoretical formulation of the person's difficulties and accompanying management plan.
An open-label, prospective trial of outpatient SIFT for adults with FND was conducted, using health-related quality of life (SF-12) as the principal outcome measure, with secondary measures of mental health, dissociation, health care use and attitude to the FND diagnosis. Measures were collected at baseline, end of treatment and 6- and 12-month follow-ups.
Twenty-nine participants with various FND symptoms enrolled. Twenty-four completed all four sessions and 25 completed follow-up measures at 12 months. SF-12 scores improved significantly at end of treatment and were sustained throughout follow-up with moderate effect sizes (0.39-0.47; all p < 0.001). Most secondary outcomes also improved significantly at all time points. The intervention was highly acceptable and tolerable to patients and perceived as beneficial.
This trial provides preliminary evidence for initial and sustained benefit from SIFT for adults with FND. Further study is needed to validate these findings.
功能性神经障碍（FND）是一种复杂的神经精神疾病，具有多因素的病因。在心理治疗试验中，很少考虑到 FND 患者的异质性，这可能导致结果的变异性。共享个体制定疗法（SIFT）是一种新的、简短的（四次疗程）心理治疗方法，旨在通过提供个人化、跨理论的困难制定和伴随的管理计划来适应异质性。
对门诊 FND 成人进行了 SIFT 的开放性、前瞻性试验，以健康相关生活质量（SF-12）为主要结果测量指标，次要结果包括心理健康、分离、医疗保健使用和对 FND 诊断的态度。在基线、治疗结束时以及 6 个月和 12 个月的随访中收集了这些测量数据。
共有 29 名患有各种 FND 症状的参与者入组。24 名参与者完成了所有四次疗程，25 名参与者在 12 个月时完成了随访测量。SF-12 评分在治疗结束时显著改善，并在随访期间保持稳定，具有中等的效应大小（0.39-0.47；均 p<0.001）。大多数次要结果在所有时间点也都显著改善。该干预措施对患者来说是高度可接受和耐受的，并被认为是有益的。
本试验为 SIFT 对 FND 成人的初始和持续获益提供了初步证据。需要进一步研究来验证这些发现。
