What is known about the rehabilitation management of functional neurological disorder in the adult physical hospital setting: A scoping review.

Abstract

Background: Functional Neurological Disorder (FND), historically known as Conversion Disorder, is a condition that lies at the intersection of physical health, mental health, and neurology as the symptoms of this condition affect the body, but the underlying cause is non-organic in nature. The reconceptualisation of FND from being considered a purely psychiatric disorder has led to a period of evolution in the way this disorder is managed within the hospital setting in recent years.

Objective: This scoping review examined the research surrounding the hospital-based management of FND after the diagnosis had been made. The aim was to explore the body of evidence surrounding this topic and draw on the many disciplines that make up the team working with this cohort of people within the hospital setting.

Methodology: Guided by the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRIMSA-ScR) a thorough search of the literature was completed and ultimately selected 16 articles for inclusion in this review.

Findings: A descriptive summary of the literature was made using a charting table, detailing the included studies characteristics, from which four themes were identified and explored: Positive communication; Charting the person’s journey; Creating an enabling environment, and Promoting recovery.

Conclusion: Findings from the review pointed towards the importance of having a cohesive and unified vision for the in-patient team working with a person with FND, with positive communication being identified as a key element. Areas of further research have been identified including the need to have a greater understanding of the person with FND’s journey in the hospital setting, as perception is a key element of the FND experience.