AIM We report results from a 5-week MDT treatment programme, with individualised sessions, for a selected group of patients with FNSD, delivered in a neuropsychiatric outpatient setting. Primary aims were to (1) reduce symptoms, (2) improve functional performance and (3) improve health status. METHODS Treatment involved individual sessions of neuropsychiatry, cognitive behavioural therapy, physiotherapy, occupational-therapy, education and family meetings. Outcome measures collected at the beginning and end of treatment and at 6 months, were patient and clinician reported. Aims were assessed by the following: symptom reduction (PHQ15, PHQ9, GAD7, SPIN, Rosenberg); health and social functioning (HONOS, WSAS); functional performance (COPM); health status (EQ-5D-5L) and patient-rated perception of improvement (CGI). RESULTS Analyses of 78 patients completing the programme and attending a 6-month review revealed high-baseline levels of disability compared to EQ-5DL population norms and high rates of disability and psychopathology as indicated by the WSAS and mental health indices (PHQ9, GAD7, SPIN, Rosenberg's self-esteem). At baseline, 92.3% met the IAPT caseness threshold for depression and 71% met the IAPT caseness threshold for anxiety. A Friedman ANOVA over the three time points and Dunn-Bonferroni post hoc tests indicated statistically significant improvements from admission to discharge and admission to 6-month follow-up. Sustained improvements were seen in somatic symptoms (PHQ15), depression (PHQ9), anxiety (GAD7), health and social functioning (HONOS), functionality (COPM), health status (EQ-5D-5L) and patient-rated clinical global improvement (CGI). CONCLUSION An MDT can effectively deliver an outpatient programme for FNSD which can serve as an alternative to costlier inpatient programmes. Early identification and treatment of co-morbidities is advised.

中文翻译：

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为期5周的功能性神经系统症状障碍（FNSD）的个性化MDT门诊（日间）治疗计划的结果。

目的我们报告了为期5周的MDT治疗方案的结果，该方案针对神经精神科门诊患者，对一组选定的FNSD患者进行了个性化治疗。主要目的是（1）减轻症状，（2）改善功能表现，（3）改善健康状况。方法治疗涉及神经精神病学，认知行为疗法，物理疗法，职业疗法，教育和家庭会议的各个环节。患者和临床医生报告了在治疗开始和结束时以及在6个月时收集的结果指标。目的通过以下方法评估：症状减轻（PHQ15，PHQ9，GAD7，SPIN，Rosenberg）；健康和社会功能（HONOS，WSAS）；功能性能（COPM）；健康状况（EQ-5D-5L）和患者对改善的感觉（CGI）。结果对78名完成该计划并参加6个月审查的患者进行了分析，结果显示与EQ-5DL人群规范相比，残疾水平较高，并且WSAS和精神健康指数（PHQ9，GAD7， Rosenberg的自尊心（SPIN）。基线时，有92.3％的人达到了IAPT抑郁症阈值，有71％的人达到了IAPT焦虑症阈值。在三个时间点的弗里德曼ANOVA和Dunn-Bonferroni事后检验表明，从入院到出院，入院到6个月的随访都有统计学上的显着改善。躯体症状（PHQ15），抑郁症（PHQ9），焦虑症（GAD7），健康和社会功能（HONOS），功能（COPM），健康状况（EQ-5D-5L）和患者评估的临床总体改善（CGI）。结论MDT可以有效地提供FNSD的门诊计划，可以代替昂贵的住院计划。建议及早发现并治疗合并症。