Multidisciplinary inpatient rehabilitation for Functional Movement Disorders: A prospective study with long term follow up

IntroductionFunctional Movement Disorders (FMDs) are challenging to treat. We assessed the effect of multidisciplinary inpatient rehabilitation, involving motor retraining, psychotherapy and psychotropic medication on FMD patient function maintenance improvement after one year.MethodsFMD patients in a movement disorders clinic were referred for rehabilitation. Baseline, discharge year follow-up measures included: Clinical Global Impression (CGI-severity, CGI-change); Depression Somatic Symptom Scale (DSSS); Generalized Anxiety Disorder-7 (GAD-7); Patient Health Questionnaire-9 (PHQ-9); Post-traumatic stress disorder check-list DSM-5 (PCL-5). Outcomes analyzed with non-parametric models.ResultsSeventeen completed Thirteen one-year follow-up. Median CGI-severity was “markedly ill.” At discharge, improved 93% (median CGI-change = 2, “much improved”) as by neurologist patient. Psychiatrist ratings showed among 86.7%; physiatrist psychologist 66.7% 53.3%, respectively. Symptoms DSSS (Wilcoxon Z −2.914, p ≤ 0.004); GAD-7 (Z −3.045, 0.002); PHQ-9 −3.415, 0.01) but not PCL-5 −1.506, 0.132). 1 year, 54% maintained at least minimal rating 77% 3, “minimally improved”). Improvement −0.385. 0.701), −0.943, 0.357) or −0.55, 0.582).ConclusionsMultidisciplinary rehabilitation function, depression, anxiety somatic symptoms. One-year demonstrated sustained worsening psychopathology, reflecting chronic debility despite initial rehabilitative success.