A Cross-Sectional Evaluation of Health Resource Use in Patients with Functional Neurological Disorders Referred to a Tertiary Neuroscience Centre

Introduction Functional Neurological Disorder (FND) is a common cause of referral to neurology services. FND has been shown to lead to significant healthcare resource use, and is associated with significant disability, comorbidity, and distress. This leads to substantial direct, indirect, and intangible costs to the patient and society. Methods We recruited consecutive patients with FND referred to a tertiary FND specialist clinic. 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 standard national unit costs. We also assessed indirect costs such as informal care and loss of income. Results We collected data on 118 subjects. Patients with comorbid anxiety or depression had higher costs in the preceding 6 months, as did patients who had a longer duration of FND symptoms. Indirect costs were larger than the already substantial direct costs, and a large proportion of FND patients were receiving government support. Conclusion This study highlights the high cost of FND to both patients and health systems. Adequate reform of the patient pathway and re-organization of services to make diagnoses, and initiate treatment more quickly, would likely reduce these costs.