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Who thinks functional neurological symptoms are feigned, and what can we do about it?
  1. Richard A A Kanaan1,2,
  2. Juen Mei Ding1
  1. 1 Department of Psychiatry, Austin Health, University of Melbourne, Melbourne, Australia
  2. 2 Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, King’s College London, London, UK
  1. Correspondence to Prof Richard AA Kanaan, Department of Psychiatry, LTB10, Austin Health, 145 Studley Road, Heidelberg VIC 3084, Australia; richard.kanaan{at}unimelb.edu.au

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Introduction

Patients with functional neurological symptoms are often suspected of feigning their symptoms. These suspicions have been reported not only in the doctors1 and nurses2 who treat them, but also in the general public who commonly infer that patients described as having functional symptoms are simply pretending to be sick.3 We found that limited education was an important determinant in who made this inference, and that even very simple additional explanation substantially reduced it.

Methods

We conducted a survey of the people waiting in a general hospital outpatient department on their understanding of a number of terms for functional neurological symptoms. These will have included patients, family members and carers. The clinics covered a range of specialties, but excluded clinics where functional neurological symptoms were likely to be common. The survey sought simple demographic data (age, gender and level of education) before presenting a hypothetical situation: ‘Imagine this scenario: You have leg weakness, and all the tests have come back negative. Your doctor may use the following terms …

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