Objective: Determine medical students’ knowledge and attitudes toward Functional Neurological Disorders (FND).

Background: Functional movement disorders are part of the spectrum of FND, a common source of neurological disability. FND are not a priority in medical education, and many health professionals are therefore self-taught when it comes to patients with FND. Previous surveys have explored attitudes towards FND among movement disorders specialists; however, little is known about what medical students know about them before finishing their medical degree (MD).

Method: A survey about FND among 6th year medical students at the University of Alcalá de Henares,Madrid. Fourteen multiple choice items and one free text question were developed to gather information on their views, experience and attitudes towards patients with FND.

Results: Eighty-four students returned the survey,70% women; mean age 23,8±2,9. Up to 82(98%) confirmed that they had studied these disorders during their MD, 57(68%) in Psychiatry exclusively and 4(4.8%) only in Neurology. In their opinion “psychosomatic” was the most common terminology used within medical circles; however, 33(39%) would choose “FND” as the most suitable term to name them. About 40% claimed to have seen more than one patient with FND during their MD, and most considered these disorders to be attended “quite frequently” in clinics. Although most students stated that patients don’t feign their symptoms, 12(14%) reported that functional symptoms are feigning, at least, partially. Physical/sexual abuse were factors considered to be common in patients with FND and most thought that these were actually present in more than 40% of patients. 41(49%) reported medical history clues and positive signs in the physical examination to be essential to perform the diagnosis. However, 36(43%) stated that the diagnosis should be performed on the basis of normal tests. More than half indicated that management is performed only by Psychiatry. In the free text, they highlighted that these patients are under-recognized, stigmatised and poorly managed and emphasised the importance of being trained on FND during the MD.

Conclusion: There is no agreement regarding the terminology within medical students but a significant proportion consider FND as the most suitable term. They think patients are not feigning and want to be well-trained on them during their MD. A more integrated view about how to perform the diagnosis is still needed.

References: 1) Baizabal-Carvallo JF, Hallett M, Jankovic J. Pathogenesis and pathophysiology of functional (psychogenic) movement disorders. Neurobiol Dis. 2019; 9961(19)30044-0. 2) Ricciardi L, Demartini B, Morgante F, Parees I, Nielsen G, Edwards MJ. Symptom severity in patients with functional motor symptoms: Patient’s perception and doctor’s clinical assessment. Parkinsonism Relat Disord. 2015;21(5):529-32.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/what-do-medical-students-think-about-functional-movement-disorders/