Neuropsychiatrist Royal Infirmary of Edinburgh and Professor University of Edinburgh, past-President of FND Society and of BNPA
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Articles by Alan Carson
Precipitating Factors for Functional Cognitive Disorder
1 Introduction Functional cognitive disorder (FCD) is the cognitive subtype of functional neurological disorder (FND) [1]. The term is used to describe cognitive symptoms that are persistent and distressing and whose distinguishing feature is the presence of internal inconsistency [2]. FCD accounts for up to a quarter of patients attending memory services [3] and is also common in other medical conditions such as chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome [4].
Functional neurological disorder: defying dualism
Functional neurological disorder (FND) is classified in the DSM-5-TR as “functional neurological symptom disorder (conversion disorder)” and in the chapter on mental disorders of the ICD-11 as “dissociative neurological symptom disorder”.
Volume 146 Issue 10
BIN1-related centronuclear myopathies are genetic diseases which result in disabling muscle weakness. Giraud et al. report that myotubularin overexpression in mice prevents and partially reverses BIN1-linked centronuclear myopathy by improving myofibre contractile properties and reducing muscle atrophy. See Asgarian et al. (https://doi.org/10.1093/brain/awad310) for a scientific commentary on this article.
Functional cognitive disorders: clinical presentations and treatment approaches
Correspondence to Dr Laura McWhirter, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; laura.mcwhirter{at}ed.ac.uk View Full Text Citation Functional cognitive disorders: clinical presentations and treatment approaches Practical Neurology 2023;23:104-110. Publication history Accepted November 13, 2022 First published December 8, 2022.
Functional cognitive disorders: clinical presentations and treatment approaches
Laura McWhirter, Alan Carson Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK Correspondence to Dr Laura McWhirter, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; laura.mcwhirter{at}ed.ac.uk Abstract Functional cognitive disorders (FCDs) are a common cause of subjective and mild cognitive impairment.
Functional cognitive disorders: clinical presentations and treatment approaches
Laura McWhirter, Alan Carson Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK Correspondence to Dr Laura McWhirter, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; laura.mcwhirter{at}ed.ac.uk Abstract Functional cognitive disorders (FCDs) are a common cause of subjective and mild cognitive impairment.
Functional cognitive disorders: clinical presentations and treatment approaches
Box 3 FCD after COVID-19 and in the context of multiple somatic symptoms A 52-year-old woman in part-time secretarial employment has a 15-year history of widespread pain for which she has received a diagnosis of fibromyalgia, and longstanding migraine since teenage years.
Network analysis characterizes key associations between subjective fatigue and specific depressive symptoms in early relapsing-remitting multiple sclerosis
Fatigue is common and disabling in multiple sclerosis (MS), yet its mechanisms are poorly understood. In particular, overlap in measures of fatigue and depression complicates interpretation. We applied a multivariate network approach to quantify relationships between fatigue and other variables in early MS. Data were collected from patients with newly diagnosed immunotherapy-naïve relapsing-remitting MS at baseline and month 12 follow-up in FutureMS, a Scottish nationally representative cohort.
Seminars in Neurology / Abstract
Cognitive behavioral therapy (CBT) is a widely used therapeutic modality in general psychiatric practice. In this review, we consider its application to neurological disorders. We examine the basic framework of CBT—that symptoms, emotions, thoughts, and behaviors are all interrelated and that therapeutic interventions that lead to change in thoughts or behavior may have the potential to reduce symptoms or emotional distress.
‘Scan-negative’ cauda equina syndrome: what to do when there is no neurosurgical cause
‘Scan-negative’ cauda equina syndrome: what to do when there is no neurosurgical cause Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
‘Scan-negative’ cauda equina syndrome: what to do when there is no neurosurgical cause
‘Scan-negative’ cauda equina syndrome: what to do when there is no neurosurgical cause http://orcid.org/0000-0001-6742-7197Ingrid Hoeritzauer1,2, Biba Stanton3, Alan Carson1,2, http://orcid.org/0000-0001-9829-8092Jon Stone1,2 1 Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK 2 Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK 3 Department of Neurology, King’s College Hospital, Neuropsychiatry Service, South London & Maudsley NHS...
Identifying functional cognitive disorder: a proposed diagnostic risk model
Published online by Cambridge University Press: 17 September 2021 Laura McWhirter [Opens in a new window] , Show author details Laura McWhirter* Affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom Craig Ritchie Affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom Jon Stone Affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, United...
‘Scan-negative’ cauda equina syndrome: what to do when there is no neurosurgical cause
‘Scan-negative’ cauda equina syndrome: what to do when there is no neurosurgical cause http://orcid.org/0000-0001-6742-7197Ingrid Hoeritzauer1,2, Biba Stanton3, Alan Carson1,2, http://orcid.org/0000-0001-9829-8092Jon Stone1,2 1Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK 2Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK 3Department of Neurology, King’s College Hospital, Neuropsychiatry Service, South London & Maudsley NHS Trust,...
Functional Neurological Disorder After SARS-CoV-2 Vaccines: Two Case Reports and Discussion of Potential Public Health Implications
Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help?
Management of traumatic brain injury (TBI): a clinical neuroscience-led pathway for the NHS
Current service provision and patient flow After trauma, the priority in the UK has been to reduce mortality after moderate/severe TBI, with the focus being on improvement of pre-hospital, acute neurosurgical and critical care, and acute or early inpatient rehabilitation.1,15 Since the introduction of the major trauma centre (MTC) system (which seeks to enable early rapid resuscitation and targeted interventions that maximise survival), patient flow and mortality have improved, particularly...
Scan-Negative Cauda Equina Syndrome
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“Scan-negative” cauda equina syndrome: A prospective cohort study
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Recognising and explaining functional neurological disorder
Intended for healthcare professionals Education Recognising and...
Occupational therapy consensus recommendations for functional neurological disorder
Abstract Background People with functional neurological disorder (FND) are commonly seen by occupational therapists; however, there are limited descriptions in the literature about the type of interventions that are likely to be helpful. This document aims to address this issue by providing consensus recommendations for occupational therapy assessment and intervention. Methods The recommendations were developed in four stages.
Occupational therapy consensus recommendations for functional neurological disorder
Occupational therapy consensus recommendations for functional neurological disorder Free http://orcid.org/0000-0002-8047-6820Clare Nicholson1, Mark J Edwards2, Alan J Carson3, Paula Gardiner4, Dawn Golder5, Kate Hayward1, Susan Humblestone6, Helen Jinadu7, Carrie Lumsden8, Julie MacLean9, Lynne Main10, Lindsey Macgregor11, Glenn Nielsen2, Louise Oakley12, Jason Price13, Jessica Ranford9, Jasbir Ranu1, Ed Sum14, http://orcid.org/0000-0001-9829-8092Jon Stone3 1 Department of Therapy Services,...
Reader response: Long-Haul COVID
Avindra Nath’s article1 makes a welcome “call to arms” for neurologists to be interested in “long-haul COVID,” noting that many sufferers are “concerned that they could be stigmatized” as having a functional disorder.
Internet-based self-help randomized trial for motor functional neurologic disorder (SHIFT)
Jeannette M. Gelauff, MD, Judith G.M. Rosmalen, PhD, Alan Carson, MBChB, MPhil, MD, Joke M. Dijk, MD, PhD, Martijn Ekkel, MD, Glenn Nielsen, PhD, Jon Stone, MB ChB, FRCP, PhD* and Marina A.J. Tijssen, MD, PhD* Jeannette M.
Performance validity test failure in clinical populations-a systematic review
Discussion Our review suggests that failure of PVTs during neuropsychological assessment is not a rare phenomenon, but is common in many clinical groups. Of note, validity test failure is particularly likely in moderate and severe TBI, and both mild and moderate-to-severe dementia (where the ‘severe impairment’ profile on the WMT often applies).
Performance validity test failure in clinical populations-a systematic review
Performance validity test failure in clinical populations—a systematic review Free http://orcid.org/0000-0001-9839-6549Laura McWhirter, Craig W Ritchie, http://orcid.org/0000-0001-9829-8092Jon Stone, Alan Carson Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK Correspondence to Dr Laura McWhirter, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH8 9YL, UK; laura.mcwhirter{at}ed.ac.uk Abstract Performance validity tests (PVTs) are widely used...
Occupational therapy consensus recommendations for functional neurological disorder
Occupational therapy consensus recommendations for functional neurological disorder http://orcid.org/0000-0002-8047-6820Clare Nicholson1, Mark J Edwards2, Alan J Carson3, Paula Gardiner4, Dawn Golder5, Kate Hayward1, Susan Humblestone6, Helen Jinadu7, Carrie Lumsden8, Julie MacLean9, Lynne Main10, Lindsey Macgregor11, Glenn Nielsen2, Louise Oakley12, Jason Price13, Jessica Ranford9, Jasbir Ranu1, Ed Sum14, http://orcid.org/0000-0001-9829-8092Jon Stone3 1Department of Therapy Services,...
Internet based self-help randomized trial for motor Functional Neurological Disorder (SHIFT).
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Telemedicine Cognitive Behavioral Therapy for Anxiety After Stroke
Ho-Yan Yvonne Chun Correspondence to: Ho-Yan Yvonne Chun, PhD, Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK. Email E-mail Address: [email protected] https://orcid.org/0000-0002-4827-0283 Centre for Clinical Brain Sciences, University of Edinburgh, UK. (H.Y.Y.C., A.J.C., M.S.D., G.E.M., W.N.W.)
‘Organic’ and ‘non-organic’: a tale of two turnips
‘Organic’ and ‘non-organic’: a tale of two turnips Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways. Copyright information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
Pseudohallucinations as functional cognitive disorders - Authors' reply
We thank Feras Ali Mustafa for his interest in our Review. We also welcome the suggestion that more thought is needed into how we conceptualise and thereafter describe poorly understood symptoms. In our view, curiosity about the nature of the subjective experience of cognitive symptoms—a phenomenological approach—will be important in helping us to better delineate primarily functional cognitive symptoms from those caused by degenerative brain disease.
Outcome Measures for Functional Neurological Disorder: A Review of the Theoretical Complexities
Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help?
Functional neurological disorder: psychiatry's blind spot
The Lancet Psychiatry Series on Women's Mental Health is a timely reminder of the importance of sex and gender in psychiatry. Although this Series could not address all disorders disproportionately affecting women, the omission of the disorder classically attributed to the uterus, functional neurological disorder, reflects a more general blind spot within psychiatry for this disorder, which remains under-researched, despite being common and highly disabling.
What should we say to patients with symptoms unexplained by disease? The “number needed to offend”
Intended for healthcare professionals Toggle navigation The BMJ logo Toggle top menu Education What should we say to... What should we say to patients with symptoms unexplained by disease?
11.48 The misdiagnosis of functional disorders as neurological disease
Parallel session 6: Clinical Neurology 2 11.48 The misdiagnosis of functional disorders as neurological disease Dennis Walzl1, Alan Carson1,2, Jon Stone1 1Centre for Clinical Brain Sciences, University of Edinburgh, Western General Hospital 2Department of Rehabilitation Medicine, NHS Lothian, Edinburgh Abstract Background When patients with functional neurological disorders are followed up, another neurological disease rarely better explains the initial symptoms in hindsight.
Functional cognitive disorders: a systematic review
1. Bell S Harkness K Dickson JM Blackburn D A diagnosis for £55: what is the cost of government initiatives in dementia case finding. Age Ageing. 2015; 44: 344-345 2. Menon R Larner AJ Use of cognitive screening instruments in primary care: the impact of national dementia directives (NICE/SCIE, National Dementia Strategy). Fam Pract. 2011; 28: 272-276 3. Stone J Pal S Blackburn D Reuber M Thekkumpurath P Carson A Functional (psychogenic) cognitive disorders: a perspective from the neurology clinic.
Physio4FMD: protocol for a multicentre randomised controlled trial of specialist physiotherapy for functional motor disorder
Study protocol Open Access Open Peer Review Published: 21 October 2019 Glenn Nielsen ORCID: orcid.org/0000-0001-6053-56701, Jon Stone ORCID: orcid.org/0000-0001-9829-80922, Marta Buszewicz ORCID: orcid.org/0000-0003-4016-58573,4, Alan Carson ORCID: orcid.org/0000-0002-7425-09642, Laura H.
Complex regional pain syndrome and functional neurological disorders - time for reconciliation
SP and IH contributed equally. Contributors SP and IH contributed equally to writing the first draft of the manuscript and conducting the literature search. LC, AJC and JS were involved in literature selection, editing and writing of the manuscript. All authors approved the final version of the manuscript. Funding SP was supported by a scholarship from the FoRUM Forschungsreferat (research office) of the Medical Faculty of the Ruhr-University Bochum, Germany.
Seeing again: treatment of functional visual loss
Seeing again: treatment of functional visual loss Jing Ming Yeo1, Alan Carson2,3, Jon Stone2 1 Department of Neurology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK 2 Centre for Clinical Brain Sciences, University of Edinburgh, Western General Hospital, Edinburgh, UK 3 Department of Rehabilitation Medicine, NHS Lothian, Edinburgh, UK Correspondence to Professor Jon Stone, Centre for Clinical Brain Sciences, University of Edinburgh, Western General...
Treating anxiety after stroke (TASK): the feasibility phase of a novel web-enabled randomised controlled trial
Pilot and Feasibility Studies20184:139 https://doi.org/10.1186/s40814-018-0329-x © The Author(s). 2018 Received: 16 March 2018 Accepted: 2 August 2018 Published: 14 August 2018 Abstract Background Anxiety affects a quarter of strokes. It can be disabling even after mild stroke and transient ischaemic attack (TIA). It is not feasible to deliver conventional psychological therapies to the large population of anxious stroke and TIA patients.
‘Cryptogenic Drop Attacks’ revisited: evidence of overlap with functional neurological disorder
Ingrid Hoeritzauer1, Alan J Carson1,2,3, Jon Stone1,3 1 Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK 2 Department of Rehabilitation Medicine, NHS Lothian, Edinburgh, UK 3 Department of Clinical Neuroscience, Western General Hospital, Edinburgh, UK Correspondence to Dr Jon Stone, Department of Clinical Neurosciences, Western General Hospital, Edinburgh, EH4 2XU, UK; Jon.Stone{at}ed.ac.uk Abstract Objective In their 1973 BMJ paper ‘Cryptogenic Drop Attacks’,...
Current Concepts in the Diagnosis and Treatment of Functional Neurological Disorders
Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders Abstract Importance Functional neurological disorders (FND) are common sources of disability in medicine. Patients have often been misdiagnosed, correctly diagnosed after lengthy delays, and/or subjected to poorly delivered diagnoses that prevent diagnostic understanding and lead to inappropriate treatments, iatrogenic harm, unnecessary and costly evaluations, and poor outcomes.
When psychiatric symptoms reflect medical conditions
When psychiatric symptoms reflect medical conditions Killian A WelchA? and Alan J Carson, consultant neuropsychiatristA, consultant neuropsychiatristB ARobert Ferguson Unit, Royal Edinburgh Hospital, Edinburgh, UK BDepartment of Clinical Neurosciences, Western General Hospital, Edinburgh, UK Address for correspondence: Dr Killian A Welch, Robert Ferguson Unit, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK.
Explaining functional disorders in the neurology clinic: a photo story
Alan Carson1, Alexander Lehn2,3, Lea Ludwig1, Jon Stone1 1Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK 2Department of Neurology, Princess Alexandra Hospital, Brisbane, Australia 3School of Medicine, University of Queensland, Brisbane, Australia Correspondence to Dr Jon Stone, Department of Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU, UK; Jon.Stone{at}ed.ac.uk Statistics from Altmetric.com Request Permissions If you wish to reuse any or...
Different shell, same shock
In both war and illness, we tell stories to frame our suffering. We create cultural narratives of national ideology or neurophysiology to cope with adversity.
‘Organic’ and ‘non-organic’: a tale of two turnips
Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways. PSYCHIATRY psychogenic CLINICAL NEUROLOGY functional disorders conversion disorder Neurologists use the word ‘organic’ a lot.
‘Organic’ and ‘non-organic’: a tale of two turnips
PSYCHIATRY psychogenic CLINICAL NEUROLOGY functional disorders conversion disorder Neurologists use the word ‘organic’ a lot. We like to think we can spot when things are ‘organic’ or indeed ‘non-organic’. But what exactly do we mean? The Oxford English Dictionary (OED) gives us eight definitions of the word organic. No wonder we get so confused by it.
‘Organic’ and ‘non-organic’: a tale of two turnips
Neurologists use the word ‘organic’ a lot. We like to think we can spot when things are ‘organic’ or indeed ‘non-organic’. But what exactly do we mean? The Oxford English Dictionary (OED) gives us eight definitions of the word organic. No wonder we get so confused by it. In the biological/medical sense it comes up with ‘Of a part of the body: composed of distinct parts or tissues (obs.); of, relating to, or of the nature of an organ or organs.
‘Organic’ and ‘non-organic’: a tale of two turnips
Neurologists use the word ‘organic’ a lot. We like to think we can spot when things are ‘organic’ or indeed ‘non-organic’. But what exactly do we mean? The Oxford English Dictionary (OED) gives us eight definitions of the word organic. No wonder we get so confused by it. In the biological/medical sense it comes up with ‘Of a part of the body: composed of distinct parts or tissues (obs.); of, relating to, or of the nature of an organ or organs.
‘Organic’ and ‘non-organic’: a tale of two turnips
Neurologists use the word ‘organic’ a lot. We like to think we can spot when things are ‘organic’ or indeed ‘non-organic’. But what exactly do we mean? The Oxford English Dictionary (OED) gives us eight definitions of the word organic. No wonder we get so confused by it. In the biological/medical sense it comes up with ‘Of a part of the body: composed of distinct parts or tissues (obs.); of, relating to, or of the nature of an organ or organs.
Functional symptoms in neurology: mimics and chameleons
Functional symptoms in neurology: mimics and chameleons Statistics from Altmetric.com Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Functional symptoms in neurology: mimics and chameleons
Functional symptoms in neurology: mimics and chameleons Jon Stone1, Markus Reuber2, Alan Carson1,3 1Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK 2Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hosptial, Sheffield, UK 3Department of Psychiatry, University of Edinburgh, Western General Hospital, Edinburgh, UK Correspondence to Dr Jon Stone, Department Clinical Neurosciences, Western General Hospital, Edinburgh EH4...
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