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Table 3 Differences between results of this Chinese survey and that of recent MDS survey (percentages of respondents)

From: Opinions and clinical practice of functional movement disorders: a nationwide survey of clinicians in China

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%

  1. Note: The blank cells indicate the differences of top options between the two surveys. For instance, incongruent MD, multiple somatizations, and emotional disturbance ranked top three necessary for Chinese neurologist in opinions of clinically definite FMD, whereas incongruent MD, functional signs, and inconsistent over time were endorsed by most MDS members