Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.
Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland.
Eur J Neurol. 2024 Jan;31(1):e16056. doi: 10.1111/ene.16056. Epub 2023 Sep 11.
Female gender, younger age and stressful life events are known predisposing factors for functional neurological disorders (FNDs). Employment in a healthcare profession has also been suggested to be a predisposing factor. We set out to conduct a large-scale case-control study to estimate the rate employment in a healthcare profession among people with FND.
We included 200 consecutive patients with a confirmed diagnosis of FND, referred to our clinic at University Hospital Bern Switzerland between October 1, 2016, and August 1, 2019. In addition, we included a control group of 200 patients with a confirmed neurological disorder, matched for age and gender, seen during the same period. The primary endpoint was to compare the prevalence of healthcare professionals between the groups. We also describe the clinical manifestations and concomitant psychiatric diagnoses in the FND cohort.
Female gender was predominant (70%), and the participants' mean age was 37 years. The proportion of healthcare professionals in the FND patients was 18% (33/186), which was significantly higher than in the control group, in which it was 10.6% (17/189; p = 0.019, 95% confidence interval odds ratio 1.168-4.074). Most healthcare professionals in both cohorts were nurses (21/33 among FND patients, 10/17 among controls). Among FND patients, 140 (70%) had motor symptoms and 65 (32.5%) had a concomitant psychiatric diagnosis.
This case-control study confirmed a higher rate of employment in healthcare professions in patients with FND, suggesting two potential mechanisms of FND: exposure to models/specific knowledge about neurological symptoms or stress-related professional factors. This warrants further studies on underlying mechanisms and prevention.
女性、年龄较小和生活压力事件是已知的功能性神经障碍（FND）的易患因素。从事医疗保健行业也被认为是一个易患因素。我们进行了一项大规模的病例对照研究，以估计 FND 患者中从事医疗保健行业的比例。
我们纳入了 2016 年 10 月 1 日至 2019 年 8 月 1 日期间在瑞士伯尔尼大学医院就诊的 200 例确诊为 FND 的连续患者。此外，我们还纳入了同期确诊为神经系统疾病的 200 例年龄和性别匹配的对照组患者。主要终点是比较两组之间医疗保健专业人员的患病率。我们还描述了 FND 队列中的临床表现和伴随的精神科诊断。
女性占主导地位（70%），参与者的平均年龄为 37 岁。FND 患者中医疗保健专业人员的比例为 18%（33/186），明显高于对照组的 10.6%（17/189；p=0.019，95%置信区间优势比 1.168-4.074）。两个队列中的大多数医疗保健专业人员都是护士（FND 患者中有 21/33 例，对照组中有 10/17 例）。在 FND 患者中，140 例（70%）有运动症状，65 例（32.5%）有伴随的精神科诊断。
这项病例对照研究证实了 FND 患者中从事医疗保健行业的比例较高，这表明 FND 有两种潜在的发病机制：接触关于神经系统症状或与压力相关的专业因素的模型/特定知识；这需要进一步研究潜在机制和预防措施。
