Connors Michael H, Quinto Lena, Deeley Quinton, Halligan Peter W, Oakley David A, Kanaan Richard A
Centre for Healthy Brain Ageing, UNSW Sydney, Sydney, Australia; Department of Psychiatry, University of Melbourne, Austin Health, Melbourne, Australia.
Forensic & Analytical Science Services, NSW Health, Sydney, Australia.
Gen Hosp Psychiatry. 2024 Jan-Feb;86:92-102. doi: 10.1016/j.genhosppsych.2023.12.006. Epub 2023 Dec 14.
Functional neurological disorder (FND) involves the presence of neurological symptoms that cannot be explained by neurological disease. FND has long been linked to hypnosis and suggestion, both of which have been used as treatments. Given ongoing interest, this review examined evidence for the efficacy of hypnosis and suggestion as treatment interventions for FND.
A systematic search of bibliographic databases was conducted to identify group studies published over the last hundred years. No restrictions were placed on study design, language, or clinical setting. Two reviewers independently assessed papers for inclusion, extracted data, and rated study quality.
The search identified 35 studies, including 5 randomised controlled trials, 2 non-randomised trials, and 28 pre-post studies. Of 1584 patients receiving either intervention, 1379 (87%) showed significant improvements, including many who demonstrated resolution of their symptoms in the short-term. Given the heterogeneity of interventions and limitations in study quality overall, more formal quantitative synthesis was not possible.
The findings highlight longstanding and ongoing interest in using hypnosis and suggestion as interventions for FND. While the findings appear promising, limitations in the evidence base, reflecting limitations in FND research more broadly, prevent definitive recommendations. Further research seems warranted given these supportive findings.
功能性神经障碍(FND)表现为存在无法用神经系统疾病解释的神经症状。FND长期以来一直与催眠和暗示相关联,这两者都曾被用作治疗方法。鉴于人们持续的兴趣,本综述考察了催眠和暗示作为FND治疗干预措施有效性的证据。
对文献数据库进行系统检索,以识别过去一百年发表的分组研究。对研究设计、语言或临床环境不设限制。两名评审员独立评估论文是否纳入、提取数据并对研究质量进行评分。
检索到35项研究,包括5项随机对照试验、2项非随机试验和28项前后对照研究。在接受任何一种干预措施的1584名患者中,1379名(87%)有显著改善,包括许多在短期内症状得到缓解的患者。鉴于干预措施的异质性和总体研究质量的局限性,无法进行更正式的定量综合分析。
研究结果凸显了长期以来人们对将催眠和暗示作为FND干预措施的持续兴趣。虽然研究结果看起来很有前景,但证据基础的局限性,更广泛地反映了FND研究的局限性,使得无法给出明确的建议。鉴于这些支持性的研究结果,进一步的研究似乎是必要的。