As I mentioned elsewhere, papers like this are an interesting reflection of psychosomatic medicine proponents scrambling to reposition themselves as the evidence comes in for physical, medically treatable causes of various health conditions that have carried the 'functional' label.
Here, the inference is that being labelled with a disorder that has a psychogenic cause is not a positive outcome for the patient. We see the terms 'psychogenic', 'somatisation' and 'conversion disorder' being replaced by 'functional disorder' not only because the patients like it, but because the house of cards doesn't fall down when the patients don't have a history of trauma, or obvious psychological issues. Or when pathologies, physical evidence of the disease, are identified. The term used can stay the same; the promoters of magic medicine can subtly shift and retain their 'expert' status.
This is talking about misdiagnosis, where two out of five people with 'clinically established functional parkinsonism' were found to have an 'underlying neurodegenerative etiology instead', a disease cause that can be treated.
More mis-diagnosis.
and more
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Here the patient had a tremor that varied with distraction - a key test for functional movement disorders according to Jon Stone (ref #5)
Surgery on identified structural spinal atrophy improved the tremor.
But, despite all this evidence that new technology and clinician diligence can keep discovering non-psychogenic causes, there is still belief in the concept of movement symptoms that arise out of nothing. Read this next paragraph, for example:
The paper tells us that functional movement disorders can coexist with actual pathology; and that a lack of identified pathology confirms a functional diagnosis. As we've mentioned elsewhere when reviewing papers that report finding actual pathology in patients as their diseases became more florid, there is a resolute clinging on to the functional diagnosis. A brain turning to mush over a matter of months is, the functional disease experts tell us, not a reason for a patient to not also have a functional disorder.
