Terminology of Functional Disorders

Enzenauer, Robert W.; Morris, William R.; O'Donnell, Thomas J.; Montrey, Jill

doi:10.1007/978-3-319-08750-4_1

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…All three terms avoid assumptions about secondary gain or aetiology, which cannot be established via ophthalmic examination. Patients presenting with NOVL may or may not have voluntary control over their symptoms as they present along a spectrum from malingering/factitious disorders to somatisation/conversion (previously “hysterical”) disorders [ 208 ].…”

Section: Resultsmentioning

confidence: 99%

VEP estimation of visual acuity: a systematic review

et al. 2020

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Purpose Visual evoked potentials (VEPs) can be used to measure visual resolution via a spatial frequency (SF) limit as an objective estimate of visual acuity. The aim of this systematic review is to collate descriptions of the VEP SF limit in humans, healthy and disordered, and to assess how accurately and precisely VEP SF limits reflect visual acuity. Methods The protocol methodology followed the PRISMA statement. Multiple databases were searched using ''VEP'' and ''acuity'' and associated terms, plus hand search: titles, abstracts or full text were reviewed for eligibility. Data extracted included VEP SF limits, stimulus protocols, VEP recording and analysis techniques and correspondence with behavioural acuity for normally sighted healthy adults, typically developing infants and children, healthy adults with artificially degraded vision and patients with ophthalmic or neurological conditions. Results A total of 155 studies are included. Commonly used stimulus, recording and analysis techniques are summarised. Average healthy adult VEP SF limits vary from 15 to 40 cpd, depend on stimulus, recording and analysis techniques and are often, but not always, poorer than behavioural acuity measured either psychophysically with an identical stimulus or with a clinical acuity test. The difference between VEP SF limit and behavioural acuity is variable and strongly dependent on the VEP stimulus and choice of acuity test. VEP SF limits mature rapidly, from 1.5 to 9 cpd by the end of the first month of life to 12-20 cpd

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Section: Resultsmentioning

confidence: 99%

VEP estimation of visual acuity: a systematic review

et al. 2020

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“…With the rise of 'functional neurological disorder' as the preferred terminology for conditions previously labelled 'hysteria' or 'psychogenic' (Edwards et al, 2014), authors have been increasingly careful to distinguish between functional disorders, malingering and other forms of illness deception (Stone et al, 2002). Nevertheless, disability that presents like neurological disorder but arises without diagnosable damage to the nervous system and is not under voluntary control ('functional neurological disorder'), is still often grouped together with the faking of symptoms under the banner of 'functional' syndrome or disorder (Berry, 2000;Enzenauer et al, 2014;Silber, 1985). Here, problems of markedly different causation, and indeed, a markedly different nature, are equally referred to as 'functional'.…”

Section: Inconsistencies In the Conceptual Scope Of The Functional-ormentioning

confidence: 99%

What is the Functional / Organic Distinction Actually Doing in Psychiatry and Neurology?

Bell¹,

Wilkinson²,

Greco³

et al. 2020

Preprint

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The functional-organic distinction aims to distinguish symptoms, signs, and syndromes that can be explained by diagnosable biological changes, from those that cannot. The distinction is central to clinical practice and is a key organising principle in diagnostic systems. Following a pragmatist approach that examines meaning through use, we examine how the functional-organic distinction is deployed and conceptualised in psychiatry and neurology. We note that the conceptual scope of the terms 'functional' and 'organic' varies considerably by context. Techniques for differentially diagnosing 'functional' and 'organic' diverge in the strength of evidence they produce as a necessary function of the syndrome in question. Clinicians do not agree on the meaning of the terms and report using them strategically. The distinction often relies on an implied model of 'zero sum' causality and encourages classification of syndromes into discrete ‘functional’ and ‘organic’ versions. Although this clearly applies in some instances, this is often in contrast to our best scientific understanding of neuropsychiatric disorders as arising from a dynamic interaction between personal, social and neuropathological factors. We also note 'functional' and 'organic' have loaded social meanings, creating the potential for social disempowerment and epistemic injustice. Given this, we argue for a better understanding of how strategic simplification and complex scientific reality limit each other. We also note that the contribution of people who experience the interaction between 'functional' and 'organic' factors has rarely informed the validity of this distinction and the dilemmas arising from it, and we highlight this as a research priority.

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What is the functional/organic distinction actually doing in psychiatry and neurology?

et al. 2020

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The functional-organic distinction aims to distinguish symptoms, signs, and syndromes that can be explained by diagnosable biological changes, from those that cannot. The distinction is central to clinical practice and is a key organising principle in diagnostic systems. Following a pragmatist approach that examines meaning through use, we examine how the functional-organic distinction is deployed and conceptualised in psychiatry and neurology. We note that the conceptual scope of the terms ‘functional’ and ‘organic’ varies considerably by context. Techniques for differentially diagnosing ‘functional’ and ‘organic’ diverge in the strength of evidence they produce as a necessary function of the syndrome in question. Clinicians do not agree on the meaning of the terms and report using them strategically. The distinction often relies on an implied model of ‘zero sum’ causality and encourages classification of syndromes into discrete ‘functional’ and ‘organic’ versions. Although this clearly applies in some instances, this is often in contrast to our best scientific understanding of neuropsychiatric disorders as arising from a dynamic interaction between personal, social and neuropathological factors. We also note ‘functional’ and ‘organic’ have loaded social meanings, creating the potential for social disempowerment. Given this, we argue for a better understanding of how strategic simplification and complex scientific reality limit each other in neuropsychiatric thinking. We also note that the contribution of people who experience the interaction between ‘functional’ and ‘organic’ factors has rarely informed the validity of this distinction and the dilemmas arising from it, and we highlight this as a research priority.

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Terminology of Functional Disorders

Cited by 3 publications

References 30 publications

VEP estimation of visual acuity: a systematic review

VEP estimation of visual acuity: a systematic review

What is the Functional / Organic Distinction Actually Doing in Psychiatry and Neurology?

What is the functional/organic distinction actually doing in psychiatry and neurology?

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