Reaching Across Party Lines– Managing Functional Neurological Disorder in the Inpatient Medical Setting

Abstract: Diagnosis and management of functional neurological disorder (FND) poses ‎many challenges for C-L psychiatrists. It is a costly psychiatric problem associated with ‎high rates of psychiatric comorbidity and physical disability (Bennet et al., 2021) that ‎requires an interdisciplinary team approach. Obstacles including lack of resources, ‎stigma (Foley et al., 2024), and miseducation (Fobian and Elliott, 2019), can compromise ‎patient care. Few hospitals have access to specialized FND clinics, leaving inpatient ‎providers and their FND patients without broad interdisciplinary management. In this ‎interactive, case-based session, we will introduce a series of tools that audience ‎members can apply to their institutions, irrespective of resource availability, to navigate ‎these hurdles and provide comprehensive care.‎
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10 minutes: Dr. Sharmeen Azher will provide an overview of the diagnosis of FND and ‎related terminology. She will review the latest evidence in epidemiology and associated ‎comorbidities.‎
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20 minutes: Medical psychologist Dr. Melissa Greenfield will present a recommended ‎approach to diagnosis of FND in the inpatient setting and review strategies for difficult ‎patient conversations using video and live role-playing.‎
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15 minutes: Dr. Alex Israel will introduce the FND Interdisciplinary Team Toolkit featuring ‎resources to help inpatient teams navigate FND. Using audience polling, Dr. Israel will ‎work through a clinical case and present best-practice guidelines for liaising with different ‎medical disciplines to achieve optimum patient care.‎
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15 minutes: Dr. Flannery Merideth will address management of psychiatric comorbidities ‎and difficult inpatient situations including disposition issues. She will guide the audience ‎through the conclusion of the clinical case while adding discharge resources and best-‎practice guidelines to the Toolkit.‎
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15 minutes: Our workshop will conclude with questions and active discussion with the ‎audience.‎
This session is sponsored by the Neuropsychiatry SIG.‎

References:

Bennett, K., Diamond, C., Hoeritzauer, I., Gardiner, P., McWhirter, L., Carson, A., & Stone, J. (2021). A practical review of functional neurological disorder (FND) for the general physician. Clinical medicine (London, England), 21(1), 28–36.

Fobian, A.D. & Elliott, L. (2019). A review of functional neurological symptom disorder etiology and the integrated etiological summary model. Journal of Psychiatry and Neuroscience, 44(1): 8–18.

Foley, C., Kirkby, A., & Eccles, F. J. R. (2024). A meta-ethnographic synthesis of the experiences of stigma amongst people with functional neurological disorder. Disability and rehabilitation, 46(1), 1–12.