Division of Psychology & Language Sciences, University College London, London, UK.
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
J Trauma Dissociation. 2024 Jul-Sep;25(4):516-532. doi: 10.1080/15299732.2024.2356591. Epub 2024 May 23.
Functional neurological disorder (FND) represents a broad group of motor and sensory clinical symptoms which cannot be explained by other neurological diagnoses. Dissociation is considered a key mechanism in their development and maintenance. Despite psychological therapy being the recommended choice of treatment for FND, evidence for its effectiveness is in its infancy. This study explored the dissociative profile of forty-seven patients with FND and evaluated whether individual psychological therapy improved dissociative symptoms, psychological distress and general functioning among twenty-five adults with FND. Patients completed the Multiscale Dissociation Inventory, the EuroQol five-dimensional descriptive system, the General Anxiety Disorder-7 scale and the Patient Health Questionnaire-9. Our sample showed high levels of disengagement, depersonalization and memory disturbance at baseline. Treatment was associated with significant improvements in general functioning, and symptoms of dissociation and anxiety. Improvements in dissociative experiences were found to be possibly due to reduction in anxiety. Improvements in depression were the strongest predictor of improvements in general functioning. Limitations and areas for further research are discussed.
功能性神经障碍（FND）代表了一大组无法用其他神经学诊断解释的运动和感觉临床症状。分离被认为是其发展和维持的关键机制。尽管心理治疗被推荐为 FND 的治疗选择，但它的有效性证据还处于起步阶段。本研究探讨了 47 名 FND 患者的分离特征，并评估了 25 名 FND 成年人的个体心理治疗是否改善了分离症状、心理困扰和一般功能。患者完成了多维分离量表、欧洲五维健康量表、广泛性焦虑症 7 量表和患者健康问卷 9。我们的样本在基线时表现出高度的脱抑制、人格解体和记忆障碍。治疗与一般功能以及分离和焦虑症状的显著改善相关。分离体验的改善可能归因于焦虑的减轻。抑郁的改善是一般功能改善的最强预测因素。讨论了局限性和进一步研究的领域。
