TY - JOUR
T1 - Functional neurological disorder in Europe
T2 - regional differences in education and health policy
AU - Serranová, Tereza
AU - Di Vico, Ilaria
AU - Tinazzi, Michele
AU - Aybek, Selma
AU - Bilic, Ervina
AU - Binzer, Stefanie
AU - Bøen, Erlend
AU - Bruggeman, Arnout
AU - Bratanov, Christo
AU - Cabreira, Veronica Raquel Alheia
AU - Golder, Dawn
AU - Dunalska, Anna
AU - Falup-Pecurariu, Cristian
AU - Garcin, Beatrice
AU - Gelauff, Jeannette
AU - Laffan, Aoife
AU - Podnar, Simon
AU - Pareés, Isabel
AU - Plender, Tom
AU - Popkirov, Stoyan
AU - Romanenko, Volodymyr
AU - Schwingenschuh, Petra
AU - Seliverstov, Yury
AU - Sjöström, Carl
AU - Škorvánek, Matej
AU - Stamelou, Maria
AU - Zailskas, Donatas
AU - Edwards, Mark J.
AU - Stone, Jon
N1 - Publisher Copyright:
© 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2024/10
Y1 - 2024/10
N2 - Background: Functional neurological disorder (FND) is a common cause of neurological disability. Despite recent advances in pathophysiological understanding and treatments, application of this knowledge to clinical practice is variable and limited. Objective: Our aim was to provide an expert overview of the state of affairs of FND practice across Europe, focusing on education and training, access to specialized care, reimbursement and disability policies, and academic and patient-led representation of people with FND. Methods: We conducted a survey across Europe, featuring one expert per country. We asked experts to compare training and services for people with FND to those provided to people with multiple sclerosis (MS). Results: Responses from 25 countries revealed that only five included FND as a mandatory part of neurological training, while teaching about MS was uniformly included. FND was part of final neurology examinations in 3/17 countries, unlike MS that was included in all 17. Seventeen countries reported neurologists with an interest in FND but the estimated mean ratio of FND-interested neurologists to MS neurologists was 1:20. FND coding varied, with psychiatric coding for FND impacting treatment access and disability benefits in the majority of countries. Twenty countries reported services refusing to see FND patients. Eight countries reported an FND special interest group or network; 11 reported patient-led organizations. Conclusions: FND is largely a marginal topic within European neurology training and there is limited access to specialized care and disability benefits for people with FND across Europe. We discuss how this issue can be addressed at an academic, healthcare and patient organization level.
AB - Background: Functional neurological disorder (FND) is a common cause of neurological disability. Despite recent advances in pathophysiological understanding and treatments, application of this knowledge to clinical practice is variable and limited. Objective: Our aim was to provide an expert overview of the state of affairs of FND practice across Europe, focusing on education and training, access to specialized care, reimbursement and disability policies, and academic and patient-led representation of people with FND. Methods: We conducted a survey across Europe, featuring one expert per country. We asked experts to compare training and services for people with FND to those provided to people with multiple sclerosis (MS). Results: Responses from 25 countries revealed that only five included FND as a mandatory part of neurological training, while teaching about MS was uniformly included. FND was part of final neurology examinations in 3/17 countries, unlike MS that was included in all 17. Seventeen countries reported neurologists with an interest in FND but the estimated mean ratio of FND-interested neurologists to MS neurologists was 1:20. FND coding varied, with psychiatric coding for FND impacting treatment access and disability benefits in the majority of countries. Twenty countries reported services refusing to see FND patients. Eight countries reported an FND special interest group or network; 11 reported patient-led organizations. Conclusions: FND is largely a marginal topic within European neurology training and there is limited access to specialized care and disability benefits for people with FND across Europe. We discuss how this issue can be addressed at an academic, healthcare and patient organization level.
KW - disability benefits
KW - education curricula
KW - functional neurological disorder
KW - healthcare
KW - patient-led organization
KW - Multiple Sclerosis/therapy
KW - Neurology/education
KW - Humans
KW - Europe
KW - Nervous System Diseases/therapy
KW - Health Services Accessibility
KW - Health Policy
KW - Neurologists
U2 - 10.1111/ene.16350
DO - 10.1111/ene.16350
M3 - Journal article
C2 - 39145716
AN - SCOPUS:85201317897
SN - 1351-5101
VL - 31
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 10
M1 - e16350
ER -