Clinical and epidemiological profile of functional neurological disorders: an observational study in a neurological rehabilitation hospital

Abstract

Background: Functional neurological disorder (FND) is a prevalent and disabling condition at the interface between neurology and psychiatry, characterized by motor, sensory, and cognitive dysfunctions that cannot be explained by structural neurological diseases. Despite its clinical relevance, epidemiological and therapeutic data are scarce, particularly in Latin America. Objective: This study aimed to characterize the clinical and epidemiological profile of patients diagnosed with FND at a neurological rehabilitation hospital. Methods: We conducted a retrospective observational study including patients diagnosed with FND according to DSM-5 criteria who were followed between 2018 and 2025. Data were obtained from the hospital’s electronic medical records, including demographics, marital status, education, occupation, prior diagnoses, and diagnostic delay. Results: Eighty-six patients were analyzed, of whom 72 (83.7%) were women and 14 (16.3%) were men. The mean age was 51.8 years, with 57% of patients between 40 and 59 years old. The youngest patient was 24 years old, and the oldest was 81. Regarding marital status, 56.98% were married or in a stable partnership, 27.91% were single, 11.63% were divorced, and 3.49% were widowed. The mean level of education was 12 years. The five most frequent occupations were homemaker, elderly caregiver, driver, teacher, and construction worker. Thirteen patients worked in healthcare, including elderly caregivers (6), nursing technicians (3), physician (1), nurse (1), physiotherapist (1), speech-language pathologist (1), community health worker (1), and massage therapist (1). FND was the primary diagnosis in 74% of cases. However, 80 patients had received another diagnosis prior to FND, most commonly neuromuscular disorders, movement disorders, and cerebrovascular diseases. Six patients had no prior diagnosis. The mean diagnostic delay was 43 months. Conclusion: The majority of patients were adult women, married or in a stable partnership, and had a secondary level of education. Only a minority worked in healthcare. Diagnostic challenges were frequent, often leading to years of delay from symptom onset and, consequently, a poorer prognosis in the rehabilitation program. These findings underscore the need for greater awareness and earlier recognition of FND in clinical practice.