The
Lancet Psychiatry Series on Women's Mental Health is a timely reminder of the importance of sex and gender in psychiatry. Although this Series could not address all disorders disproportionately affecting women,
the omission of the disorder classically attributed to the uterus, functional neurological disorder, reflects a more general blind spot within psychiatry for this disorder, which remains under-researched, despite being common and highly disabling.
1
Patients with functional neurological disorder present with neurological symptoms inconsistent or incongruent with typical pathophysiological disease;
they are presumed to be psychological in origin. Although hysteria was once deemed, infamously, to be an exclusively female disorder, its women-to-men sex ratio is approximately 2–3:1.
1 Conversion disorder became the prominent term, reflecting Sigmund Freud's theory that psychological traumas are converted into physical symptoms. Functional neurological disorder became an official term in
DSM-5 and is becoming dominant as a result of patient preference, with widespread use in online support groups.
2 This nomenclature is causally neutral, and this is reflected in the DSM-5 classification, which no longer requires a psychological precipitant as an essential diagnostic criterion—an important development.
