de Liège A, Carle G, Hingray C, Lehn A, Autier L, Degos B, Garcin B
Service de Neurologie, AP-HP, Hôpital Avicenne, Université Sorbonne Paris Nord, Bobigny, France.
Consultation-Liaison Psychiatry and Psychiatric Emergency Department, Toulouse University Hospital, Toulouse, France.
Rev Neurol (Paris). 2022 Oct;178(8):788-795. doi: 10.1016/j.neurol.2022.03.018. Epub 2022 Jul 19.
FND is a disabling disease that accounts for 5 to 10% of the reason for consultation in neurology. However, young physicians often say they have little or no training in their management.
The aim of the present study was to assess whether French junior neurologists, psychiatrists and physical and rehabilitation medicine (PRM) specialists received teaching on FND during their medical studies, including the residency, and to evaluate their knowledge and perception of the disorder.
The survey was distributed by the means of a Google form questionnaire to specialist registrars and young specialists with the help of resident's organizations.
568 respondents from the 3 specialties were included in the study. Most respondents (72.4%) were specialists registrars. Almost half of the respondents (45.5%) answered they never received any teaching on FND, and only 20.5% of them knew the Hoover's sign, a positive sign specific of functional weakness. A large majority of respondents felt they were not sufficiently trained in FND (87.9%), and they did not have sufficient knowledge of these disorders (85.3%).
Better training would allow clinicians to make a diagnosis earlier, to better explain it to patients, and to limit the costs associated with diagnosis delays. A better training of clinicians about FND would also improve the prognosis of patients, as early diagnosis and good explanation is associated with a better prognosis.
This survey shows that there is a gap about FND in the training programs in the medical studies and during the specialization training of young doctors in France.
功能性神经疾病(FND)是一种致残性疾病,占神经内科门诊就诊原因的5%至10%。然而,年轻医生常表示他们在该疾病的管理方面几乎没有接受过培训。
本研究旨在评估法国年轻的神经科医生、精神科医生以及物理医学与康复医学(PRM)专家在其医学学习(包括住院医师培训)期间是否接受过关于FND的教学,并评估他们对该疾病的知识和认知。
借助住院医师组织,通过谷歌表单问卷的方式向专科住院医师和年轻专家发放调查问卷。
来自这三个专业的568名受访者纳入了研究。大多数受访者(72.4%)是专科住院医师。几乎一半的受访者(45.5%)回答他们从未接受过关于FND的任何教学,只有20.5%的人知道胡佛征,这是功能性肌无力的一个特异性阳性体征。绝大多数受访者认为他们在FND方面没有得到充分的培训(87.9%),并且他们对这些疾病没有足够的了解(85.3%)。
更好的培训将使临床医生能够更早地做出诊断,更好地向患者解释病情,并减少与诊断延迟相关的费用。对临床医生进行关于FND的更好培训也将改善患者的预后,因为早期诊断和良好的解释与更好的预后相关。
这项调查表明,在法国年轻医生的医学学习培训计划以及专科培训期间,关于FND的培训存在差距。