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Suggestibility in functional neurological disorders
  1. Stoyan Popkirov1,
  2. Timothy R Nicholson2
  1. 1 Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
  2. 2 Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
  1. Correspondence to Stoyan Popkirov, Neurologie, Knappschaftskrankenhaus Bochum Langendeer, Bochum 44892, Germany; popkirov{at}

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A meta-analysis shows increased suggestibility in patients with functional neurological disorders

From the simple message of ‘I will please’ (Latin placēbō) encapsulated in a sugar pill, to the famous theatrics of Jean-Martin Charcot’s hypnotic seizure inductions and treatments (figure 1), implicit and explicit narratives of healing and illness have been noted to exert a particularly strong influence on functional neurological disorder (FND). Although the placebo effect is near universal in medicine, and cultural frameworks are relevant for any illness experience, expectancy plays a more central mechanistic role in FND.1 Techniques of suggestion are still occasionally used in neurology practice, specifically to diagnose functional motor deficits by demonstrating reversibility,2 or to provoke dissociative seizures during video electroencephalography monitoring to enable a definitive diagnosis.3

Figure 1

The painting ‘Une leçon clinique à la Salpêtrière’ (1887) by André Brouillet depicts Jean-Martin Charcot inducing neurological symptoms through hypnotic suggestion. His student Joseph Babiński (pictured holding the patient) later proposed changing the term hysteria to pithiathism (from Ancient Greek peíthō, meaning ‘I convince’), emphasising the suggestibility of symptoms as a cardinal feature. Source: …

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  • Twitter @popkirov, @Tim_R_Nicholson

  • Contributors SP and TRN drafted and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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