Impact of waiting time on the outcome of a group therapy intervention for patients with functional neurological disorders

Mohammed K. Quraishi 1, Hammad Sadique 1, Andrea E. Cavanna 1,2,3

1 Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, United Kingdom; 2 School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, United Kingdom; 3 Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and University College London, London, United Kingdom

Objective

The clinical management of patients with functional neurological disorders can be challenging and often involves neuropsychiatric input. Relatively little is known about factors affecting clinical outcomes following treatment interventions in this patient population. This retrospective study evaluated the care pathway based on group therapy intervention for adult patients with functional neurological disorders attending a specialist neuropsychiatry clinic.

Methods

We retrospectively reviewed the care pathways of 67 consecutive adult outpatients referred to group therapy sessions for functional neurological disorders, focusing on outcome predictors.

Results

The mean length of the care pathway (from referral to neuropsychiatry to first contact with therapists) in patients rated as clinically improved was significantly lower than the duration of the care pathway of patients who did not show any improvement: 37.8 weeks compared to 52.1 weeks, respectively (p < 0.03). There were no other significant differences between the groups in either demographic or clinical variables.

Conclusions

Longer waiting times were found to negatively affect clinical outcomes of group therapy sessions for functional neurological disorders in a neuropsychiatry setting. Clinicians should be aware of the possible impact of waiting times on the care pathways of patients with functional neurological disorders. Streamlined care pathways for early intervention in this clinical population should be prioritized.

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