Functional neurological symptoms and their correlates across four Asian samples : should they be classified as a dissociative disorder?

Abstract

Whether functional neurological symptom disorder should be classified as a dissociative disorder remains a subject of debate. This multi-site, cross-cultural study investigated functional neurological symptoms and psychoform dissociation among college students in the Philippines (N = 219), Turkey (N = 160), Malaysia (N = 240), and Taiwan (N = 766). Across the four samples, between 50.0 % and 74.2 % of participants with functional neurological symptoms exhibited co-occurring psychoform dissociative symptoms. Controlling for confounding variables (e.g., age, gender, childhood adversities, and symptoms of depression, anxiety, and complex PTSD), psychoform dissociative symptoms emerged as the strongest and most robust correlate of functional neurological symptoms in three out of four samples (Philippines: β = .502, Turkey: β = .665, Malaysia: β = .541). Psychoform dissociative symptoms were also significantly associated with functional neurological symptoms in the Taiwan sample (β = .122), although not the strongest predictor. The results that were replicated across four culturally different samples support classifying functional neurological symptom disorder as possibly dissociative in nature in future ICD and DSM. Individuals who present with functional neurological symptoms should be screened for dissociative disorders.