Background

Functional Neurological Disorder (FND) is a complex neuropsychiatric condition with a multifactorial aetiology. The heterogeneity of patients with FND is rarely considered in psychotherapy trials, which may contribute to variable outcomes. Shared Individual Formulation Therapy (SIFT) is a new, brief (four session) psychotherapy that aims to accommodate heterogeneity by providing a personalised, trans-theoretical formulation of the person’s difficulties and accompanying management plan.

Methods

An open-label, prospective trial of outpatient SIFT for adults with FND was conducted, using health-related quality of life (SF-12) as the principal outcome measure, with secondary measures of mental health, dissociation, health care use and attitude to the FND diagnosis. Measures were collected at baseline, end of treatment and 6- and 12-month follow-ups.

Results

Twenty-nine participants with various FND symptoms enrolled. Twenty-four completed all four sessions and 25 completed follow-up measures at 12 months. SF-12 scores improved significantly at end of treatment and were sustained throughout follow-up with moderate effect sizes (0.39–0.47; all p < 0.001). Most secondary outcomes also improved significantly at all time points. The intervention was highly acceptable and tolerable to patients and perceived as beneficial.

Conclusion

This trial provides preliminary evidence for initial and sustained benefit from SIFT for adults with FND. Further study is needed to validate these findings.

中文翻译：

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共享个体配方疗法 (SIFT)：一项适应功能性神经障碍患者异质性的新疗法的开放标签试验

背景

功能性神经障碍 (FND) 是一种具有多因素病因的复杂神经精神疾病。FND 患者的异质性在心理治疗试验中很少被考虑，这可能会导致不同的结果。共享个人配方疗法 (SIFT) 是一种新的、简短（四次）的心理疗法，旨在通过提供针对个人困难的个性化、跨理论的配方和随附的管理计划来适应异质性。

方法

对患有 FND 的成人门诊 SIFT 进行了一项开放标签、前瞻性试验，使用健康相关生活质量 (SF-12) 作为主要结果指标，次要指标是心理健康、分离、医疗保健使用和态度FND 诊断。在基线、治疗结束和 6 个月和 12 个月的随访时收集测量值。

结果

招募了 29 名具有各种 FND 症状的参与者。24 人完成了所有四个疗程，25 人在 12 个月时完成了后续措施。SF-12 评分在治疗结束时显着改善，并在整个随访期间持续，效应量适中（0.39-0.47；所有p  < 0.001）。大多数次要结果在所有时间点也有显着改善。这种干预对患者来说是高度可接受和耐受的，并且被认为是有益的。

结论

该试验为患有 FND 的成年人从 SIFT 中获得初始和持续益处提供了初步证据。需要进一步的研究来验证这些发现。