Steve October 26, 2020

Oct. 23 (UPI) — Functional neurological disorders in the United States rack up roughly $1.2 billion in costs for emergency room and in-hospital care, according to an analysis published Friday by JAMA Neurology.

Because these type of disorders are difficult to diagnose, much of the money goes to testing and evaluation “at the expense of necessary, but neglected, psychiatric and rehabilitative treatments,” the researchers said.

The disorders can appear as walking or gait difficulties, limb weakness, sensory and cognitive problems, abnormal body movements or seizure-like episodes.

“We found that [these] patients had … higher levels of imaging tests, such as MRIs and CT scans, as well as electroencephalograms [and] spinal taps, but they had low rates of the kind of treatment that they need, including psychiatric consultation, physical, occupational or speech therapy,” study co-author Dr. Christopher D. Stephen told UPI.

“What our study shows is that the costs of functional neurological disorders are high and rising and comparable to other conditions where … a lot of money is allocated to research and treatment,” said Stephen, an instructor in neurology at Harvard Medical School and attending neurologist at Massachusetts General Hospital.

Perhaps not as well known as diseases such as multiple sclerosis and epilepsy, functional neurological disorders account for up to 10% of all neurology-related hospital admissions in the United States, according to Stephen.

Up to 40,000 people nationally have the disorders, research suggests, and, for many, their symptoms symptoms “are felt to result from an underlying psychological process,” Stephen said.

Still, “functional neurological disorders are are very underappreciated, as they are actually very common. But most people have never heard of them and they are unfortunately neglected, given small amounts of funding allocated to clinical care and research for this vulnerable and unfortunately still stigmatized population,” he said.

For this study, Stephen and his colleagues reviewed emergency-room and hospital admission and billing data for more than 36,000 adults and 3,800 children with functional neurological disorders in the United States over a 10-year period, from 2008 through 2017.

Adults with these disorders spent more than $1.1 billion on hospital care in 2017, while care for children cost nearly $100 million annually, the researchers said.

Emergency evaluations for people with these disorders more frequently resulted in admission to the hospital — in roughly two-thirds of all adults and on-third of children — compared to those with other neurological conditions, the data showed.

Although these patients typically had shorter hospital stays — about five days, on average — than those with other neurological diseases — about six days, on average — they underwent up to twice as many diagnostic tests, according to the researchers.

Conversely, adults and children with functional neurological disorders were about half as less likely to receive rehabilitative treatment services such as physical therapy, occupational therapy, speech and language pathology and psychiatric consultation than those with other neurological disorders, the researchers said.

“My hope is that putting some number on the cost of functional neurological disorders … may influence change in terms of increased funding for the multidisciplinary care that is vital for these patients,” Stephen told UPI.

“Psychiatric care has long been inadequate for [people] in the U.S. and hopefully greater understanding and acknowledgement that psychiatric disorders are still brain-based conditions will help reduce stigma and improve quality of care,” he said.

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