BACKGROUND Cognitive symptoms in the absence of neurological disease are common. Functional cognitive disorder (FCD) has been conceptualized as a cognitive subtype of functional neurological disorder. Although FCD is understood as different from exaggerated or feigned cognitive complaints, previous accounts have provided little practical advice on how FCD can be separated from factitious or malingered cognitive complaints. Also, the distinction of FCD from other medical or mental health disorders that impact on cognition is an area of ongoing study and debate. Diagnostic precision is important to prevent iatrogenesis and for the development of needed treatment protocols. METHOD We summarize the current literature and present seven anonymized case vignettes to characterize the challenges in this area and develop proposals for solutions. RESULTS/CONCLUSIONS Recognizing the limitations of categorical diagnostic systems, we position FCD as distinct from feigning and cognitive symptoms of psychiatric disorders, although with overlapping features. We set out typical clinical features and neuropsychological profiles for each category of cognitive disorder and a statistical method to analyze performance validity tests/effort tests to assist in determining feigned or invalid responding.

中文翻译：

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功能性认知障碍：常见临床表现的鉴别诊断。

背景技术在没有神经系统疾病的情况下出现认知症状是常见的。功能性认知障碍（FCD）已被概念化为功能性神经障碍的认知亚型。尽管 FCD 被理解为与夸大或假装的认知抱怨不同，但以前的叙述几乎没有提供关于如何将 FCD 与人为或伪装的认知抱怨区分开来的实用建议。此外，FCD 与其他影响认知的医学或精神健康障碍的区别是一个正在进行的研究和辩论的领域。诊断精度对于预防医源性和制定所需的治疗方案很重要。方法 我们总结了当前的文献并提出了七个匿名案例小插曲，以描述该领域的挑战并提出解决方案的建议。结果/结论 ​​认识到分类诊断系统的局限性，我们将 FCD 定位为与精神疾病的假装和认知症状不同，尽管具有重叠的特征。我们列出了每一类认知障碍的典型临床特征和神经心理学概况，以及一种分析性能有效性测试/努力测试的统计方法，以帮助确定假装或无效的反应。