Functional Neurological Disorder (FND) - articles, social media and discussion

From Dave's article linked above.

"Unfortunately, this sort of data-mashing contributes to the ongoing confusion among clinicians, patients and the public over FND, the larger domain of what are being called “functional” disorders, and the critical differences between the two. To mitigate this confusion, issue, the mis-citations of the key SNSS findings in published papers–specifically the erroneous claims that the study found an FND prevalence of 16% and that FND was the second-most common diagnostic outcome–should be corrected."

Well, to the pro-FND 'researchers', there is no critical difference, it would seem fairly obvious that they believe the two things are the same. In my opinion they do share one similarity, that once they are investigated properly (and if need be after the appropriate technology becomes available) all will become explainable in terms of biological processes and without resorting to software/hardware dualism.
 
Journal of Psychosomatic Research

McGhie-Fraser et al, 2023

Quality assessment and stigmatising content of Wikipedia articles relating to functional disorders

"Introduction

While the internet is an increasingly popular place for people to access health information, the quality of information varies significantly between sources and clinical topics [1,2]. Wikipedia is a prominent resource for the public, patients and healthcare professionals. Articles can be created and edited by anonymous users in almost 300 languages, which can result in differences in information quality. Low quality or inaccurate health information has the potential to mislead patients, contributing to unrealistic expectations or poor decision making [3]. This is clearly seen in functional disorders, where inaccurate beliefs and negative attitudes are widespread.

Functional disorders is an umbrella term for a group of recognisable medical conditions which are thought to be due to changes to the functioning of the systems of the body rather than due to a disease affecting the structure of the body. To our knowledge there is no evidence about the quality of online information relating to functional disorders. In this study we analysed the quality and stigmatising content of Wikipedia articles in multiple languages."
 
Is that distinction between the systems and structures of the body standard and commonplace? I’d understand a system to include multiple interacting parts of a given structure, so if an FD is an illness involving failures of more than one bodily component, they are welcome to the term, and it would be a fair hunch to assume that ME is a FD.

But this is the journal of psychosomatic medicine, so presumably they are using the terms in some other coded way, and the intent is to stigmatise while painstakingly avoiding stigmatising language, because it upsets these hypochondriacs if clinicians speak plainly.
 
When I read things like that, I wonder who is funding that sort of work which, as @Shadrach Loom says, is really about making the diagnosis of something very similar to hypochondria and hysteria more palatable to patients. The first author is based at Radboud University Medical Center, Radboud Institute for Health Services Research, Department of Primary and Community Care, Nijmegen, the Netherlands.
This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 956673.
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The authors would like to thank Anne Toussaint and Paul Hüsing for the conceptualisation of this research and proposal of the quality rating framework.
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On those two people who conceptualised the research:
Anne Toussaint seems to be a key proponent of "somatoform disorders"; her bio is full of papers on the topic e.g.
Barriers to the diagnosis of somatoform disorders in primary care: protocol for a systematic review of the current status.
A European research network to improve diagnosis, treatment and care for patients with persistent somatic symptoms: Work report of the EURONET-SOMA conference series.
Comparing the Patient Health Questionnaire - 15 and the Somatic Symptom Scale - 8 as measures of somatic symptom burden.
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Same for Paul Hüsing
Somatic symptom disorder: A scoping review on the empirical evidence of a new diagnosis
Helpful explanatory models for persistent somatic symptoms: a randomized controlled pilot study (HERMES)
From the identification of biopsychosocial risk factors to an increase in pain-related self-efficacy (IDRIS) – The online-based conveyance of an explanatory model for chronic back pain: Study protocol of a cohort multiple randomized controlled trial
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In contrast, we don't have any agency funding people to trawl though Wikipedia and report on the stigmatising language about ME/CFS and other post-infection conditions.
 
We remain shocked that this clinical entity we don’t understand looks like this construct we think it is. This is the addled logic these people not only endorse, but fervently celebrate.
 

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CRG said:
Functional disorders is an umbrella term for a group of recognisable medical conditions which are thought to be due to changes to the functioning of the systems of the body rather than due to a disease affecting the structure of the body
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But that's the public lie version, not the real one. They can pretend all they want, the conversion disorder is nothing but mythical baggage carried from Freud, it never had any validity, it's only around because there is mass cowardice in medicine about acknowledging systemic harm.

The lie that it isn't what it lies about is part of the construct, they never mean what they say or say what they mean because it's too nasty to admit, and completely lacks validity and evidence.
 
Sean said:
Functional symptoms remain highly misunderstood within medicine.

Then how can you so confidently classify them as 'functional?
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Hey, if they didn't have double standards, they wouldn't have any.

The mere possibility that it "can" be is used to mean 100% guaranteed for psychosomatics. Meanwhile massive evidence that the underlying cause is clearly immunological is dismissed because it's not proven 100%. You literally cannot have a more ridiculous imbalance than this, as invalid as a criminal trial ruled based on the alleged innuendo of an unnamed person overruling solid evidence beyond reasonable doubt. Those are literally features of an invalid legal system precisely because of how much abuse of this kind it opens up.
 
Twitter thread from Putrino Lab on why Long Covid isn't an FND.
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I think this
"So, what *is* FND anyway? Anyone who works in FND has to admit that over the years it has always been a problematic diagnosis with far too many unskilled and uninformed clinicians considering it to be synonymous with conversion disorder (read: “psychosomatic illness”)"
misses the point that many FND researchers still see it as "synonymous with conversion disorder", even stating so in their publications.
 
Putrino is a staunch advocate for people with Long Covid. But he talks about "settled science" while listing a whole lot of findings on the pathology of Long Covid that are far from settled. It's a problem we have discussed often here - holding up preliminary findings of biological pathology to refute statements that Long Covid and ME/CFS are psychogenic illnesses can backfire badly.
 
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