eprintid: 10087248
rev_number: 23
eprint_status: archive
userid: 608
dir: disk0/10/08/72/48
datestamp: 2019-12-05 16:50:45
lastmod: 2021-09-20 22:33:28
status_changed: 2019-12-05 16:50:45
type: article
metadata_visibility: show
creators_name: Jones, A
creators_name: O'Connell, N
creators_name: David, AS
creators_name: Chalder, T
title: Functional Stroke Symptoms: A Narrative Review and Conceptual Model
ispublished: pub
divisions: UCL
divisions: B02
divisions: C07
divisions: D79
keywords: Functional Symptoms, Model and Intervention, Narrative Review, Stroke
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: Stroke services have been reconfigured in recent years to facilitate early intervention. Throughout stroke settings, some patients present with functional symptoms that cannot be attributed to a structural cause. Emphasis on fast diagnosis and treatment means that a proportion of patients entering the care pathway present with functional symptoms that mimic stroke or have functional symptoms in addition to vascular stroke. There is limited understanding of mechanisms underlying functional stroke symptoms, how the treatment of such patients should be managed, and no referral pathway or treatment. Predisposing factors vary between individuals, and symptoms are heterogeneous: onset can be acute or insidious, and duration can be short-lived or chronic in the context of new or recurrent illness cognitions and behaviors. This article proposes a conceptual model of functional symptoms identified in stroke services and some hypotheses based on a narrative review of the functional neurological disorder literature. Predisposing factors may include illness experiences, stressors, and chronic autonomic nervous system arousal. Following the onset of distressing symptoms, perpetuating factors may include implicit cognitive processes, classical and operant conditioning, illness beliefs, and behavioral responses, which could form the basis of treatment targets. The proposed model will inform the development of theory-based interventions as well as a functional stroke care pathway.
date: 2020
date_type: published
official_url: https://doi.org/10.1176/appi.neuropsych.19030075
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1719874
doi: 10.1176/appi.neuropsych.19030075
lyricists_name: David, Anthony
lyricists_id: ADDAV87
actors_name: David, Anthony
actors_id: ADDAV87
actors_role: owner
full_text_status: public
publication: The Journal of Neuropsychiatry and Clinical Neurosciences
volume: 32
number: 1
pagerange: 14-23
event_location: United States
issn: 0895-0172
citation:        Jones, A;    O'Connell, N;    David, AS;    Chalder, T;      (2020)    Functional Stroke Symptoms: A Narrative Review and Conceptual Model.                   The Journal of Neuropsychiatry and Clinical Neurosciences , 32  (1)   pp. 14-23.    10.1176/appi.neuropsych.19030075 <https://doi.org/10.1176/appi.neuropsych.19030075>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10087248/3/David_Functional%20Stroke%20Symptoms.%20A%20Narrative%20Review%20and%20Conceptual%20Model_AAM.pdf