Liens entre troubles neurologiques fonctionnels et évènement traumatique : enjeux dans la relation médecin–malade

Abstract

ObjectivesThe complex care of patients with functional neurological disorders (FND) has been the subject of many studies. However, none that we know of has explored the experience of the physician–patient relationship with FND patients who have suffered a potentially symptom-inducing traumatic event. The aim of this article is to understand how the evocation of a traumatic event affects FND patients’ experience of the physician–patient relationship and its integration into patients’ narratives around their symptoms. MethodsThree case studies from our ongoing doctoral research will be described. This research is being carried out in the neuro-myology unit at the Pitié-Salpêtrière Hospital in Paris, France. We chose quantitative (questionnaires) and qualitative (semi-directed interviews) methods to bring to light the intra-individual similarities and differences that occur frequently in this population. ResultsAccepting that the traumatic event participates in the creation of symptoms does not mean the patient will completely agree with their psychogenic nature. Patients can feel stigmatized, which can reveal already present psychological weaknesses that may be related to the traumatic event (fear of abandonment and repetition compulsion, amongst others). DiscussionThis article explores the plurality of experiences of FND patients in their physician–patient relationship and underlines the importance and value of close collaborations between physicians and mental health professionals with this population. ConclusionsThis article raises questions about further work with this population: it would be of interest to explore the experience of patients directed to mental health professionals and to compare our results to those of patients who do not cite any traumatic event in particular.