Psychiatric Comorbidities in Functional Movement Disorders: A Retrospective Cohort Study, 2021, Macchi et al

ABSTRACT

Background
Functional movement disorders (FMD) are characterized by abnormal movements and motor symptoms incongruent with a known structural neurologic cause. While psychological stressors have long been considered an important risk factor for developing FMD, little is known about the impact of psychiatric comorbidities on disease manifestations or complexity.

Objectives
To compare characteristics of FMD patients with co-occurring mood and trauma-related psychiatric conditions to FMD patients without psychiatric conditions.

Methods
We performed a retrospective cohort study of patients seen in the University of Colorado Health system between January 1, 2015 and December 31, 2019. Patients were included if they had a diagnosis of FMD, determined by ICD-10 coding and ≥1 phenomenology-related diagnostic code (tremor, gait disturbances, ataxia, spasms, and weakness), and at least one encounter with a neurology specialist. Fisher's exact and unpaired t-tests were used to compare demographics, healthcare utilization, and phenomenologies of patients with psychiatric conditions to those with none.

Results
Our review identified 551 patients with a diagnosis of FMD who met inclusion criteria. Patients with psychiatric conditions (N = 417, 75.7%) had increased five-year healthcare utilization (mean emergency room encounters 9.9 vs. 3.5, P = 0.0001) and more prevalent non-epileptic seizures (18.2% vs. 7.5%, P = 0.001). Suicidal ideation (8.4%) and self-harm (4.1%) were only observed amongst patients with comorbid psychiatric conditions.

Conclusions
Patients with FMD and comorbid psychiatric conditions require more healthcare resources and have greater disease complexity than patients without psychiatric illness. This may have implications for treatment of patients without comorbid psychiatric conditions who may benefit from targeted physiotherapy alone.

Paywall, https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mdc3.13226

 

I was going to write an answer, but, you know what, I can't be bothered. No amount of trials can make up for a rubbish pseudoscientific diagnosis that is state sanction quackery.

 

It's not exactly hard to see that "psychiatric comorbidities" are commonly misdiagnosed in this patient population and basically all they are doing is finding that they did. Which is like mailing yourself a Christmas letter and being happy that you received a Christmas letter. Good for you, means nothing.

Honestly moving forward I will never be able to take seriously anything coming out of psychiatry. This field is intellectually bankrupt.