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Title: Functional weakness
Author: Stone, J.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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107 patients with functional weakness (79% female), 46 with neurological weakness and 39 health controls were recruited and eligible for the study, suggesting a minimum incidence of functional weakness of between 2.8-3.9/100,000/yr - similar to multiple sclerosis. The mean age was 39 years, by chance, in all groups and the duration of weakness was similar (11 vs 14 months). Patients with functional weakness described relatively consistent symptoms with a higher proportion complaining of pain (p<0.0001) than the neurological controls. There was more psychiatric disorder, particularly current depression (32% vs 7%), panic disorder (36% vs 13%) and somatization disorder (27% vs 0%) in the functional group vs the neurological group although self-reported emotional distress on the SF-36 and HAD was similar between groups. Paradoxically, patients with functional weakness were much less likely than the neurological control group to blame their symptoms on stress (56% vs 24%, p<0.001). The functional group were twice as likely as controls to have given up work (65% vs.33%, p<0.0005) because of their symptoms, despite having similar levels of disability There was more adverse childhood and marital experience, and a greater frequency of previous surgery in the functional group compared to all controls. There was not a higher frequency of ‘illness models’ for weakness in the functional group. In the functional group there was a history of panic / dissociation (37%) and/or physical injury (14%) at onset in many cases. Conclusion: Patients with functional weakness are common and as disabled as patients with neurological weakness of similar duration. They have more psychiatric disorder than patients with neurological weakness but may not report this readily in questionnaires and rarely wish to connect it with their physical symptoms.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available