Descriptions | Chinese survey | Recent MDS survey (2018) |
---|---|---|
More than 3 FMD patients seen monthly | 18.5% | 34% |
Identifying a comorbid organic neurological disorder ‘sometimes’ or ‘frequently’ | 37.7% | 41% |
Concerned about missing another organic diagnosis in FMD patients | 55.7% | 64% |
Role and responsibility (more than providing a diagnosis) | 94.5% | 99.1% |
Disliking seeing FMD patients | 24.7% | 29% |
Necessary for clinically definite FMD (top three) | ||
Incongruent MD | 84.8% | 60.7% |
Multiple somatizations | 82.3% | |
Emotional disturbance | 80.9% | |
Functional signs | 78.1% | |
Inconsistent over time | 51.6% | |
Use suggestion to assist with diagnosis | 29.5% | 43.1% |
Use placebo to assist with diagnosis | 17.7% | 8.8% |
Request neurological investigations before diagnosing | 58.1% | 47% |
Electrophysiology for confirmation | 89.8% | 60% |
Discuss results of the electrophysiology testing with patients (‘often’ and ‘always’) | 29.1% | 21.2% |
Non-FMD diagnosis indicators (top three) | ||
A prior organic diagnosis | 60% | 43% |
Lack of non-physiologic deficits | 52% | |
Physical injury | 50% | 37% |
Extremes of age | 36% | |
Refer patients | ||
Neuropsychiatrist or psychiatrist experienced in FMD | 77.4% | |
General Psychiatrist | 56% | |
Very and extremely effective treatments (top three) | ||
Psychotherapy with antidepressant/ anxiolytic treatment | 59.2% | |
Avoiding iatrogenic harm | 35.5% | 58% |
Educating the patient | 32.7% | 53% |
Rehabilitation services | 40% | |
Limitations in managing patients | ||
Lack of treatment guidelines | 47.3% | 39% |
Physician knowledge/training | 32.9% | |
Cultural beliefs about psychological illnesses | 27.2% | 50% |
Availability of referral services | 48% | |
Important for indicating a better prognosis (top three) | ||
Early diagnosis of FMD | 76.2% | |
Identification and management of concurrent psychiatric disorder | 72.6% | About 85% |
Acceptance of the diagnosis by the patient | 65.0% | More than 90% |
Identification and management of psychological stressors | About 84% | |
Educating a patient (‘most of the time’ and ‘always’) | ||
Discuss potential for reversibility/improvement | 56.2% | 90% |
Discuss possible role psychological factors | 53.7% | 85% |