How clinicians explain a diagnosis of functional neurological disorder: A qualitative study with general practitioners, neurologists, psychologists and physiotherapists

INTRODUCTION: Functional neurological disorders (FND) are a frequent reason for consultation in neurology, characterized by symptoms that can impair various functions, without any identifiable lesion. Diagnosis plays a key role in patient adherence to treatment and the improvement of outcomes. However, the diversity of terms used to describe FND and etiological uncertainties reflect a lack of consensus, which may affect communication between healthcare professionals and patients. This raises the question of how healthcare providers explain the diagnosis of FND. OBJECTIVE: To explore similarities and differences in the language used by physicians, physiotherapists, and psychologists to explain FND to patients. METHOD: An exploratory qualitative study was conducted using individual semi-structured interviews with physicians, physiotherapists, and psychologists who had encountered at least one case of FND in the course of their practice. RESULTS: FND are associated with heterogeneous conceptualizations among healthcare professionals, ranging from psychological to neurological approaches. Despite this diversity marked by uncertainty, recognizing symptoms while reassuring patients remains essential. Diagnosis disclosure constitutes a complex process for clinicians due to its potential impact on patients, requiring appropriate communication to foster therapeutic alliance. This step requires an interprofessional dynamic, which is sometimes hindered by communication challenges and inconsistent narratives that disrupt care pathways. In this context, developing a common language emerges as a key imperative. CONCLUSION: This study highlights the importance of establishing coordinated care pathways for FND patients, which rely on harmonized communication among healthcare practitioners. Although resources exist, their implementation appears to be limited.