PsychEd Episode 71: Functional Neurological Disorder with Dr. Patricia Rosebush

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode covers Functional Neurological Disorder with Dr. Patricia Rosebush. Dr. Rosebush is a Professor in the Department of Psychiatry & Behavioural Neurosciences at McMaster University. She is the distinguished author of numerous articles on clinical neuroscience, including considerable work on mitochondrial disorders in mental illness and over 30 papers on catatonia, and practices consultation-liaison psychiatry at St. Joseph’s Healthcare Hamilton.The learning objectives for this episode are as follows:Provide a definition and conceptual approach to FNDIdentify clinical signs and patient histories relevant to a diagnosis of FNDDescribe an approach to the treatment of FNDUnderstand the special challenges of communication and collaboration in this illnessGuest: Dr. Patricia RosebushHosts: Dr. Alastair Morrison, Dr. Kate BraithwaiteAudio editing: Dr. Alastair MorrisonShow notes: Dr. Kate BraithwaiteInterview content:(02:39) Learning objectives(03:09) Conceptualization of FND(08:30) Underlying psychological processes(09:35) Difference between FND and factitious disorder/malingering(14:54) Alexithymia(16:51) Common symptomatic presentations(18:00) Types of underlying stressors(19:17) Other risk factors for FND(22:12) Communicating with patients to address stigma(24:32) Psychotherapy in FND(29:36) Referral pathways for patients with FND(31:15) Prognosis of FND(33:09) Social media and FNDResources:Functional Neurological Disorder Society. Functional Neurological Disorder Society (FNDS). Includes a podcast and courses for physiciansFunctional Neurological Disorder (FND) – A Patient's Guide to FNDReferences:Hull, M., & Parnes, M. (2021). Tics and TikTok: Functional Tics Spread Through Social Media. Movement disorders clinical practice, 8(8), 1248–1252. https://doi.org/10.1002/mdc3.13267National Institute for Neurological Disorders and Stroke. (2024, July.) Functional Neurological Disorder.  U.S. Department of Health and Human Services, National Institutes of Health. Functional Neurologic Disorder | National Institute of Neurological Disorders and StrokePsychDB. (2024, April). Conversion Disorder (Functional Neurological Disorder. Conversion Disorder (Functional Neurological Disorder) - PsychDBRosebush, P. I., & Mazurek, M. F. (2011). Treatment of conversion disorder in the 21st century: have we moved beyond the couch?. Current treatment options in neurology, 13(3), 255–266. https://doi.org/10.1007/s11940-011-0124-yScamvougeras, A., & Castle, D. (2024). Functional Neurological Disorders: Challenging the Mainstream Agnostic Causative Position. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 69(7), 487–492. https://doi.org/10.1177/07067437241245957For more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website at psychedpodcast.org.