From the Guidelines
The guideline approach to functional cognitive disorder involves a comprehensive management strategy that begins with a thorough explanation of the diagnosis to the patient, addressing psychosocial predisposing and perpetuating factors, and incorporating cognitive behavioral therapy (CBT) principles to help the patient notice and challenge unhelpful thoughts. This approach is supported by the most recent and highest quality study, which emphasizes the importance of addressing psychological and social factors in the management of functional neurological disorder (FND) 1.
Key Components of Management
- Providing reassurance about the non-degenerative nature of the condition while acknowledging the reality of the patient's symptoms
- Addressing underlying contributors, including treating comorbid depression or anxiety with appropriate medications, improving sleep hygiene, and managing stress
- Incorporating CBT principles to help the patient notice and challenge unhelpful thoughts, such as catastrophizing or "all or nothing" thoughts 1
- Encouraging physical exercise, aiming for at least 150 minutes of moderate activity weekly
- Using cognitive rehabilitation techniques to help patients develop compensatory strategies for memory difficulties
Addressing Cognitive Symptoms
- Cognitive symptoms are common in FND and can be addressed through a combination of CBT, cognitive rehabilitation, and lifestyle modifications
- Helping the patient to understand the link between potential contributing factors and cognitive function is essential, and discussions should aim to normalize these experiences and reframe the symptom as part of FND rather than an additional health problem 1
Multidisciplinary Approach
- A multidisciplinary approach, including occupational therapy, speech and language therapy, and psychology, is essential in the management of FND
- Occupational therapists can help patients with FND to develop strategies to manage their symptoms and improve their quality of life, and can provide education and support to patients and their families 1
From the Research
Guideline Approach to Functional Cognitive Disorder
There are no research papers to assist in answering this question as the provided studies do not directly address functional cognitive disorder.
Related Information on Cognitive-Behavioral Therapy
- Cognitive-behavioral therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, obsessive-compulsive and tic disorders, personality disorders, eating disorders, and insomnia 2.
- The overall goal of CBT is to replace dysfunctional constructs with more flexible and adaptive cognitions 3.
- Stepped care approaches have been shown to be effective and resource-efficient in treating common mental disorders, leading to high remission rates with limited therapist resources 4, 5.
Stepped Care Models
- Stepped care models involve a stepped approach to treatment, with patients first receiving low-intensity interventions and then being stepped up to more intensive interventions if needed 4, 5.
- Guided self-help (GSH) CBT has been shown to be effective in treating common mental disorders, and can be used as a first step in a stepped care model 4.
- Face-to-face CBT can be used as a second step in a stepped care model for patients who do not respond to GSH CBT 4.