Objective: It has been argued that the label given to unexplained neurological symptoms is an important contributor to their often poor acceptance, and there has been recent debate on proposals to change the name from Conversion Disorder. There have been multiple studies of layperson and clinician preference and this article aimed to review these.Design: Multiple databases were searched using terms including "conversion disorder" and "terminology", and relative preferences for the terms extracted.Results: Seven articles were found which looked at clinician or layperson preferences for terminology for unexplained neurological symptoms. Most neurologists favoured terms such as "functional" and "psychogenic", while laypeople were comfortable with "functional" but viewed "psychogenic" as more offensive; "Non-epileptic/organic" was relatively popular with both groups.Conclusions: "Functional" is a term that is relatively popular with both clinicians and the public. It also meets more of the other criteria proposed for an acceptable label than other popular terms -however the views of neither psychiatrists nor actual patients with the disorder were considered.

Please cite this article as: Ding Juen Mei, Kanaan Richard Antony Alexander, What should we say to patients with unexplained neurological symptoms? How explanation affects offence, Journal of Psychosomatic Research (2016Research ( ), doi:10.1016Research ( /j.jpsychores.2016 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Tables: 3 Figures: 3 References: 27 A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT ABSTRACTObjectives: Unexplained neurological symptoms (UNS) are common presentations in neurology but there is no consensus as to what they should be called. This is important, as patient acceptance is a predictor of outcome and there is evidence that patients are unhappy with the terms used. Patient understanding of these terms may be limited, however, and, once explained, the terms may seem more or less offensive. We sought to elicit patients" views of 7 frequently used terms for UNS, and whether these changed once definitions were provided.Methods: 185 participants were recruited from a medical outpatients" waiting area. They were given questionnaires outlining a hypothetical situation of leg weakness, with 7 possible labels.Participants were asked whether they endorsed 4 connotations for each label and the "number needed to offend" (NNO) calculated, before and after definitions were given.

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