Gardien, J. (Jona) (2017) Psychiatrische karakteristieken bij patienten met een functionele bewegingsstoornis : een cohort studie. thesis, Medicine.
Full text available on request.Abstract
A functional motor disorder (FMD) is defined by inconsequent, involuntary movements, that are not caused by an underlying (neurological) disease. The disorder can consist of several types of motor symptoms, such as tremor, myoclonus, dystonia, functional weakness and gait disturbances. FMD is often characterized by a long duration of illness, reduced quality of life and is known to be highly associated with psychiatric comorbidity. It’s hypothesized that the psychiatric phenotype differs in patients with different motor symptoms. This study explores the variety in psychopathology within FMD, as is reported by patients and neurologists. Data about the quality of life and limitations in daily functioning are also included. Method Patients (men and women, all above 18 years of age and diagnosed with FMD) were included in this survey from the multi-centered RCT (the Self-help and Education on the Internet for Functional Motor Disorders Trail - SHIFT). We divided the population based on of the most important self-reported motor complaint in five groups: tremor, myoclonus, dystonia, functional weakness and gait disturbances. Depression (PHQ-9), anxiety (PHQAnxiety, GAD-7), quality of life (WHOQOL-BREF) and impairment of daily life functioning (RAND-36) caused by physical restrictions, emotional problems or pain were measured, based on self-report in an online questionnaire. These data were compared in different FMDgroups. Furthermore, we analyzed the neurologist’s correspondence of the patient to determine whether or not psychopathology was reported. Data extracted from the correspondence was compared to the questionnaire data. In a post-hoc analysis we used a new format: we composed groups with the same diagnosis as set by neurologist and analyzed their reported psychiatric complaints. Results We found no significant differences in prevalence and severity of psychiatric disorders in the different FMD-groups (p>.05). Patients with gait disorders reported significantly more limitations in daily life functioning caused by their physical restrictions than patients with functional dystonia or functional tremor (p<.0038). There were no other significant differences found in this study (p>.05). Prevalence of psychiatric comorbidity as reported by the neurologists was highest in patients with functional dystonia (45.0%). In the post hoc study the prevalence of depression differed significantly between groups (p<.05). There were no significant differences found in the other outcomes. Conclusion Patients with different types of FMD do not differ in their psychiatric phenotype. Our findings show that the degree of difference in psychiatric comorbidity in the FMD-groups is determined by the method by which the distinction between the groups is made. Prospective studies, based on data collected in much larger groups, is recommended to come to more definite conclusions.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleiders: and Gelauff, Drs. J. M.arts onderzoeker neurologie UMCG and Koning-Tijssen, Prof. Dr. M.A. J. de neuroloog UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/965 |
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