Dr David Tuller: FND Experts Agree To Correct Inflated Prevalence Claim

Countrygirl

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Dr David Tuller: FND Experts Agree To Correct Inflated Prevalence Claim

https://virology.ws/2023/06/24/trial-by-error-fnd-experts-agree-to-correct-inflated-prevalence-claim/?fbclid=IwAR1kA2CgfO0yYiP8bHllHajPSbQ0Nf8-DHM9hq2G4GZjGVAuoF5aRgmqrjo
10 Comments / By David Tuller / 24 June 2023

By David Tuller, DrPH
For years, experts in functional neurological disorder (FND) have cited a seminal study in their field to claim that the diagnosis was the second-most-common presentation at outpatient neurology clinics, with a prevalence of 16%. This claim was, and is, categorically untrue. The Scottish Neurological Symptoms Study (SNSS), which yielded multiple papers about a dozen years ago, actually found that 209 out of 3781, or 5.5%, were identified as having conversion symptoms. (Conversion disorder is the old name for FND.) At that rate, it was the eighth-most-common presentation in the SNSS, not #2.

This discrepancy was pointed out to me a year or so ago by a valued source. I blogged and posted on social media about the issue. I also wrote—twice–to a major journal seeking a correction in one such paper. I received no response. Two weeks ago, I sent a letter seeking a correction to another major journal, NeuroImage: Clinical. Several colleagues—from Berkeley, Columbia, Johns Hopkins, University College London, etc—co-signed the letter.
The authors have now agreed to correct the false statement that the SNSS found FND to be the second-most-common presentation. The correction is inadequate in some respects. Nevertheless, I hope it means that they will at least no longer cite the SNSS to claim FND is the #2 presentation at outpatient neurology clinics, with a prevalence of 16%. I also hope the FND experts themselves will now initiate corrections in the dozens of papers that have included these untrue data points. It will be a tedious process for all involved if our group has to send out letters to journal editors about every single one of these papers.
 

BrightCandle

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The basic problem I have with FND, beyond the amount of misdiagnosis of it, is there is zero evidence that any of it actually exists from a physical point of view. They don't have research showing brain wiring being wrong or even large areas of the brain waves being off. It is at best a theory with no treatment options and a symptom pattern that overlaps a lot of conditions. Given the amount of times real diseases are misdiagnosed as FND that alone is a good reason to just not do anything further with it since in practice it's just the latest rename of hysteria. Lots of long haulers in the UK have got an FND diagnosis and it's horrendous how the psychologists just keep renaming the same basic theory and keep getting called out for it.
 

Wishful

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I just ignore anything with "FND" in the title, because as BrightCandle said, it's just the latest rename of hysteria: a label for "We don't know how to deal with these patients, and putting an official label on it means the problem is solved."
 

Azayliah

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Even if it's a real thing, the diagnosis and treatment is completely unhelpful. They said I had it, and that I'm doing everything I should to treat it. But I still have the same movement and physical weakness issues that led them to diagnose me with it in the first place. Useless.
 
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