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The Complexity of the Diagnostic Pathway of Children With a Functional Neurological Symptomatology Disorder

Recruiting
6 - 17 years of age
Both
Phase N/A

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Overview

The goal of this qualitative and quantitative cross-sectional observational study is to describe the complexity of the diagnostic pathway for Functional Neurological Symptomatology Disorder (TSNF) in children and adolescents based on the experience of the different protagonists of care (parents, adolescents, caregivers).

The main question[s] it aims to answer are:

  • How do the various stakeholders experiences the care pathway for children and adolescents with a diagnosis of TSNF
  • What are their expectations regarding the diagnosis and management of TSNF Participants will be enrolled in interviews in which they will describe their experience. Parents will also answer a lifestyle questionnaire.

Description

Conversion Disorder (CD) or Functional Neurological Symptomatology Disorder (FNSD) is a pathology characterized by the occurrence of non-simulated physical symptoms of neurological appearance in the absence of underlying organic pathology.

The hyperspecialization of medicine makes the therapeutic approach to FNSD very complex for several reasons:

  • Pediatric health professionals are trained to diagnose and treat physical disorders and are at a loss when it comes to psychological disorders
  • Physicians often increase the number of complementary tests before making a diagnosis of FNSD, for fear of missing a serious or urgent pathology
  • Psychiatric diagnosis is a diagnosis of exclusion, and TSNF is therefore often evoked at the end of the treatment, which leads to wandering in the patient's care This delay in diagnosis does not allow patients to receive appropriate care and the consequences can be serious.

The objective of this mixed qualitative and quantitative study is to study the complexity of the care pathway of patients aged 6 to 18 years with a diagnosis of TSNF, as well as their parents and the health professionals who have taken care of them. The collection of their experience will be done by means of semi-structured interviews which will then be analyzed according to the Interpretative Phenomenological Analysis.

Eligibility

Inclusion Criteria:

  • Patients
    • Child or adolescent, boy or girl, aged 6 to 17 years inclusive, treated at the Clermont-Ferrand University Hospital for a conversion disorder diagnosed by a psychiatrist during the past year
    • Presence or not of a follow-up in child psychiatry after the diagnosis
    • Agreement of the legal representatives for participation in the study.
    • Affiliation to a Social Security system.
  • Parents / legal representatives
    • Adult subject, parent or legal representative of a child or adolescent meeting the above-mentioned inclusion criteria and participating in the study
  • Health professionals
    • Person affiliated with the Clermont-Ferrand University Hospital, with experience in caring for children or adolescents with a conversion disorder (pediatrician, psychiatrist, nurse, psychologist,
  • For all participants
    • Able to give informed consent to participate in the research.
    • Proficiency in the French language [NB the written language must be mastered by the parents to answer the questionnaires].

Exclusion Criteria:

  • For all participants: Present a decompensated somatic or psychiatric pathology or a disorder of vigilance compromising the realization of the research, refusal to participate in the research.

Study details

Conversion Disorder in Children

NCT05746637

University Hospital, Clermont-Ferrand

25 January 2024

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