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Shared Individual Formulation Therapy (SIFT): an open-label trial of a new therapy accommodating patient heterogeneity in functional neurological disorder

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A Correction to this article was published on 05 October 2021

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Abstract

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.

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Acknowledgements

The authors would like to thank Dr Ralf Ilchef of the Consultation Liaison Psychiatry Department, and Dr Mark Thieben of the Neurology Department at Royal North Shore Hospital for their support of this research.

Funding

The RANZCP Foundation has provided financial support for this research through the Beverley Raphael New Investigator Grant (2017)/Psychotherapy Research Award (2019).

Author information

Authors and Affiliations

  1. Department of Psychiatry, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia

    M. Gutkin & R. A. Kanaan

  2. Department of Consultation–Liaison Psychiatry, Royal North Shore Hospital, St Leonards, New South Wales, Australia

    M. Gutkin, L. McLean & J. Streimer

  3. Division of Psychology and Mental Health, The University of Manchester, Manchester, UK

    R. J. Brown

  4. Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK

    R. J. Brown

  5. Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia

    L. McLean

Authors
  1. M. Gutkin
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  2. R. J. Brown
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  3. L. McLean
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  4. J. Streimer
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  5. R. A. Kanaan
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Contributions

MG conceived of and carried out the intervention, analysed data and wrote the manuscript. RB and RK contributed to research design, data interpretation and contributed to the manuscript. LM contributed to intervention, research design, clinical supervision and final drafts of the manuscript. JS contributed to intervention design, clinical supervision and final drafts of the manuscript.

Corresponding author

Correspondence to M. Gutkin.

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Conflicts of interest

The authors declare no conflict of interest.

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Gutkin, M., Brown, R.J., McLean, L. et al. Shared Individual Formulation Therapy (SIFT): an open-label trial of a new therapy accommodating patient heterogeneity in functional neurological disorder. J Neurol 268, 4882–4889 (2021). https://doi.org/10.1007/s00415-021-10797-y

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  • DOI: https://doi.org/10.1007/s00415-021-10797-y

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