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2025 ; 15
(10
): e101122
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Prevalence and impact of comorbid PTSD, c-PTSD and EUPD on symptom severity in
functional neurological disorder: protocol for a systematic review and
meta-analysis
#MMPMID41101963
Davies S
; Rafi D
; Rifkin-Zybutz R
; Heyland S
; Jadhakhan F
BMJ Open
2025[Oct]; 15
(10
): e101122
PMID41101963
show ga
INTRODUCTION: Previous trauma and adverse life experiences have been hypothesised
to be aetiological factors for functional neurological disorder (FND) leading to
the hypothesis of a 'trauma-subtype' of FND. Individuals who have experienced
prior abuse are more likely to develop FND than healthy controls. Post-traumatic
stress disorder (PTSD) and personality disorders have been described to be
comorbid with FND at varying prevalence rates. Complex PTSD (c-PTSD) and
emotionally unstable personality disorder (EUPD) have clinical similarities with
PTSD and trauma is a common aetiological factor in the development of all three
conditions. There is some research exploring the resemblance of personality
traits in populations diagnosed with FND and EUPD compared with controls.
However, it remains unclear what the current prevalence rates are of PTSD, c-PTSD
and EUPD in populations diagnosed with FND. Understanding the overlap between
these trauma-based comorbid psychiatric diagnoses with FND will hopefully inform
better and more comprehensive trauma-informed treatment strategies. The aims of
the systematic review are therefore to (1) establish the prevalence of PTSD,
c-PTSD and EUPD in adults diagnosed with FND and (2) compare core FND symptom
severity between adults with FND alone and those with comorbid PTSD, c-PTSD and
EUPD. METHODS AND ANALYSIS: This systematic review will assess the prevalence of
PTSD, c-PTSD and EUPD in FND patients aged over 18, diagnosed using standardised
questionnaires or clinical interviews as per international diagnostic criteria.
Studies will be identified through comprehensive searches of databases including
PsycINFO, PsycARTICLES, CINAHL, MEDLINE, EMBASE, Web of Science and Scopus, from
May 1990 to May 2025. The review aims to estimate the prevalence of these
conditions in FND, with findings presented as a narrative description discussing
contributing factors, and a meta-analysis considered if heterogeneity is
suitable. ETHICS AND DISSEMINATION: Ethical approval is not required since only
data from existing studies will be used and no original data will be collected.
Results will be disseminated at national and international academic conferences
and in peer-reviewed publications. Any deviations from this protocol will be
recorded and explained in the final report and updated on PROSPERO. PROSPERO
REGISTRATION NUMBER: CRD42024599112.