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Neurological Dysfunction in Long COVID Should Not Be Labelled as Functional Neurological Disorder 2023 Van der Feltz-Cornelis, Moriaty and Strain

Discussion in 'Long Covid research' started by Andy, Mar 22, 2023.

  1. Andy

    Andy Committee Member

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    Location:
    Hampshire, UK

    Abstract

    There have been suggestions that Long COVID might be purely functional (meaning psychological) in origin. Labelling patients with neurological dysfunction in Long COVID as having functional neurological disorder (FND) in the absence of proper testing may be symptomatic of that line of thought. This practice is problematic for Long COVID patients, as motor and balance symptoms have been reported to occur in Long COVID frequently. FND is characterized by the presentation of symptoms that seem neurological but lack compatibility of the symptom with a neurological substrate. Although diagnostic classification according to the ICD-11 and DSM-5-TR is dependent predominantly on the exclusion of any other medical condition that could account for the symptoms, current neurological practice of FND classification allows for such comorbidity. As a consequence, Long COVID patients with motor and balance symptoms mislabeled as FND have no longer access to Long COVID care, whereas treatment for FND is seldom provided and is ineffective.

    Research into underlying mechanisms and diagnostic methods should explore how to determine whether motor and balance symptoms currently diagnosed as FND should be considered one part of Long COVID symptoms, in other words, one component of symptomatology, and in which cases they correctly represent FND. Research into rehabilitation models, treatment and integrated care are needed, which should take into account biological underpinnings as well as possible psychological mechanisms and the patient perspective.

    Open access, https://www.mdpi.com/1999-4915/15/3/783
     
    livinglighter, Lisa108, Sean and 5 others like this.
  2. Andy

    Andy Committee Member

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    21,810
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    Hampshire, UK
  3. Grigor

    Grigor Senior Member (Voting Rights)

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    I don't have the brainpower to read it at the moment. I agree with the title. With the abstract I'm less impressed.
     
  4. Ariel

    Ariel Senior Member (Voting Rights)

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    "Research into rehabilitation models, treatment and integrated care are needed, which should take into account biological underpinnings as well as possible psychological mechanisms and the patient perspective."

    Doesn't this sentence kind of undermine the motivation for and contradict the title of the paper? This is what the FND people say they are doing.
     
    Sean, Lilas, Grigor and 4 others like this.
  5. Charles B.

    Charles B. Senior Member (Voting Rights)

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    This is essence of what the BPS model purports to be. Carson and Stone would cite their clinics as the paradigmatic examples of this very ethos. What was Strain thinking, unless he’s now imbibed the Kool-Aid too?
     
  6. rvallee

    rvallee Senior Member (Voting Rights)

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    12,299
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    Canada
    Any claim lacking real world evidence can be dismissed without evidence and there is no evidence for the mythical conversion disorder, it was always as imaginary as the humors. It should not need evidence to be disproved, Russel's teapot is not assumed to be there unless not found and people saying they swear they saw it out there in outer space is about as good evidence against as there can be that these people should be ignored on all matters of importance.

    Which is how it should be called. FND is explicitly used to mean conversion disorder without saying it. So it should instead read that it should not be labeled as conversion disorder. But this editorial accepts the framing that conversion disorder is a thing, which is just as problematic.

    And for the magical rehabilitation yet again. Surely if people try the same thing they have been asserting as effective for decades for a few more centuries they will surely come up with narratives that they believe in. That's about all that can be said to be true here. This is the same mentality that thinks poor people can just work harder and they won't be poor anymore. It's BS.

    Mental health care has basically become metamedicine, it makes it all about thinking about disease and illness or behaving in unhealthy ways, which isn't really a thing. It has completely dismissed even the possibility that illness affecting the brain is a valid explanation. The brain has been completely separated from the rest of the body, like it's in its own special dimension of spacetime.

    We can't wait for this broken system to help us. It won't, it's not even capable of thinking in terms that are useful to us. The patient community has to do like the AIDS movement and do it all. Nothing will happen otherwise to help any of us.
     
    alktipping, Willow, Mithriel and 3 others like this.

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