A Cross-Sectional Evaluation of Health Resource Use in Patients with Functional Neurological Disorders Referred to a Tertiary Neuroscience Centre
Brian O'Mahony1, Mahinda Yogarajah2, Robert Nelson-Sice3
1IOPPN, 2Neurology, St George's Hospital, 3St George's Hospital
Objective:
To investigate the direct, indirect, and intangible costs of Functional Neurological Disorder
Background:
Functional Neurological Disorders (FND) are a collection of neurological symptoms which arise despite lack of an identifiable pathophysiological disease process. FND has been shown to lead to significant healthcare resource use, and are associated with significant disability, comorbidity, and distress. This leads to substantial direct, indirect, and intangible costs to the patient and society writ large.
Design/Methods:
We assessed health and social care resource use, in the 6 months preceding their consultation through a modified version of the Client Service Receipt Inventory (CSRI) in the form of a postal questionnaire. The total cost was estimated by combining the number and frequency of health resource use with recognized sources of national unit costs. We also assessed indirect costs such as informal care and loss of employment income
Results:
We collected data on 118 subjects. Patients with comorbid anxiety or depression were shown to have higher cost in the preceding 6 months. Indirect costs to patients were larger than the already substantial direct costs, and a large proportion of FND patients were receiving government support
Conclusions:
This study highlights the high cost of FND to both patients and the NHS.. Adequate reform of the patient pathway and re-organization of NHS services to make diagnoses and initiate treatment more quickly would likely reduce these costs. 
10.1212/WNL.0000000000201911