Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK.
Research Department of Clinical, Educational and Health Psychology, University College, London, UK.
Arch Clin Neuropsychol. 2022 Aug 23;37(6):1158-1176. doi: 10.1093/arclin/acac020.
Cognitive symptoms in the absence of neurological disease are common. Functional cognitive disorder (FCD) has been conceptualized as a cognitive subtype of functional neurological disorder. Although FCD is understood as different from exaggerated or feigned cognitive complaints, previous accounts have provided little practical advice on how FCD can be separated from factitious or malingered cognitive complaints. Also, the distinction of FCD from other medical or mental health disorders that impact on cognition is an area of ongoing study and debate. Diagnostic precision is important to prevent iatrogenesis and for the development of needed treatment protocols.
We summarize the current literature and present seven anonymized case vignettes to characterize the challenges in this area and develop proposals for solutions.
RESULTS/CONCLUSIONS: Recognizing the limitations of categorical diagnostic systems, we position FCD as distinct from feigning and cognitive symptoms of psychiatric disorders, although with overlapping features. We set out typical clinical features and neuropsychological profiles for each category of cognitive disorder and a statistical method to analyze performance validity tests/effort tests to assist in determining feigned or invalid responding.
在没有神经疾病的情况下出现认知症状很常见。功能性认知障碍（FCD）被认为是功能性神经障碍的认知亚型。尽管 FCD 被理解为与夸大或佯装的认知抱怨不同，但之前的描述几乎没有提供如何将 FCD 与虚假或佯装的认知抱怨区分开来的实际建议。此外，FCD 与影响认知的其他医疗或心理健康障碍的区分是一个正在研究和争论的领域。诊断的准确性对于预防医源性疾病和制定必要的治疗方案很重要。
我们总结了当前的文献，并提出了七个匿名案例描述，以描述该领域的挑战，并提出解决方案。
结果/结论：认识到分类诊断系统的局限性，我们将 FCD 定位为与佯装和精神障碍的认知症状不同，尽管有重叠的特征。我们列出了每种认知障碍类别的典型临床特征和神经心理学特征，以及一种分析绩效有效性测试/努力测试的统计方法，以帮助确定佯装或无效反应。
