A meta-ethnographic synthesis of the experiences of stigma amongst people with functional neurological disorder

Abstract

Purpose

Functional neurological disorder (FND) causes many neurological symptoms and significant disability. It is often misunderstood by medical professionals and the public meaning stigma is regularly reported. The aim of this review was to synthesise the qualitative findings in the literature to develop a more in-depth understanding of how people with FND experience stigma to inform future interventions.

Method

This review used a meta-ethnography approach. Five databases were searched (PsycINFO, Web of Science, CINAHL, MEDLINE, and EMBASE) in February 2021 and updated in July 2022 for qualitative papers in FND. Included papers were critically assessed using the critical appraisal skills programme (CASP) checklist. Data were analysed and synthesised utilising meta-ethnography.

Results and conclusion

Sixteen papers were included in the final synthesis. Four major themes emerged: stigmatized by delegitimization; stigmatized by social exclusion and rejection; coping with stigma; and stigma and identity. The results identified negative, stigmatizing attitudes towards people experiencing FND symptoms in a variety of contexts including healthcare and other social institutions. The effects of stigma led to further exclusion for participants and appeared to trigger coping styles that led to additional difficulty. Stigma is a key part of the illness experience of FND and needs to be addressed.

Implications for Rehabilitation

• Functional neurological disorders can cause a significant degree of disability for those individuals who experience them.

• This experience appears to be compounded by stigma these people encounter as a result of their illness in their day-to-day lives as well as in their contact with institutions including education, workplaces, and healthcare.

• A potential strategy to reduce the impact of stigma is through raising awareness of the reality of this condition which may be achieved through education targeted towards healthcare providers.

Keywords:

• Functional neurological disorder
• stigma
• meta-ethnography
• functional movement disorder
• functional seizures

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Correction

Correction Statement

This article was originally published with errors, which have now been corrected in the online version. Please see Correction (http://dx.doi.org/10.1080/09638288.2023.2170107).

Acknowledgements

The authors would like to thank Miss Janeen Kirwan who assisted in the quality review of the papers and Subject Librarians Tanya Williamson and John Barbrook for their help in planning the searches.

Disclosure statement

No potential conflict of interest was reported by the author(s).