Clinical Trial: Treatment of Functional Movement Disorders With Psychotherapy

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Treatment of Functional Movement Disorders With Psychotherapy

Brief Summary:

Background:

- Functional movement disorder (FMD) is a form of conversion disorder (CD). CD is a disorder in which a person has neurological symptoms that do not have a neurological cause. These symptoms can include pain, weakness, dizziness, and fatigue. Some thoughts on CD suggest that it may come from feelings of anxiety that are converted into physical symptoms. Treatment for FMD usually involves stress reduction, family help, and regular doctor s appointments. Therapy interventions, however, have not been well studied. Researchers want to see if people with FMD get better with psychotherapy. They will study two different types of psychotherapy: group therapy and a self-help manual.

Objectives:

- To test two different types of therapy treatments for FMD.

Eligibility:

- Individuals at least 18 years of age who have been diagnosed with FMD by a neurologist.

Design:

  • Participants will be screened with a physical exam and medical history. They will also have a psychological exam, and answer questions about their mood and symptoms.
  • Participants will be separated into three groups. One group will have group therapy. Another will use a self-help workbook designed for people with FMD, and have individual therapy sessions. A third group will just have standard care. During the study, participants will continue to see their regular doctor.
  • Group therapy participants will meet once a week for 6 months at the National Institutes of Health clinical center. There will be 8 to 10 people per

    Detailed Summary:

    Objectives:

    This is an exploratory study of two options for treating functional movement disorders (FMD):

    • Group psychotherapy
    • Cognitive behavioral therapy (CBT)-based guided self-help.

    Study population:

    We intend to study adult patients with diagnoses of FMD seen by the Human Motor Control Section Clinic (HMCS) and who live in the Washington-Baltimore metropolitan area for group psychotherapy as well as patients who live out of the area for CBT-based guided self-help.

    Design:

    Patients will be screened for participation through protocol 07-N-0190 ( Neurobiology of Psychogenic Movement Disorder and Non-Epileptic Seizures ). Those who meet the inclusion criteria and who live locally will be invited to participate in a treatment study of group psychotherapy. The duration of the study for each patient is one year. Local patients who meet the inclusion criteria will be divided into two groups of 10 patients each. Accrual will be gradual. All 10 patients in each group will start simultaneously. All participants will undergo an initial assessment, followed by an assessment at 3, 6, and 12 months. The primary endpoint will be assessed at 6 months. At the end of the study, all subjects will undergo the same MRI studies they completed as part of protocol 07-N-0190 baseline assessment. Patients will be evaluated with the scales described below.

    Those who meet the inclusion criteria and who live locally will be invited to participate in a treatment study of group psychotherapy. Local patients who meet the inclusion cr
    Sponsor: National Institute of Neurological Disorders and Stroke (NINDS)

    Current Primary Outcome: Ability to participate in social roles and activities (Neuro-QOL Item Bank) [ Time Frame: 6 months ]

    Original Primary Outcome: Same as current

    Current Secondary Outcome:

    • Somatic symptoms (SCL-90). [ Time Frame: at baseline ]
    • Self assessment of disease severity (5 point Likert scale). [ Time Frame: 3 months ]
    • Subjective and objective depressive and anxiety symptoms. [ Time Frame: 6 months ]
    • Clinical Global impression of severity (CGI). [ Time Frame: 12 months ]


    Original Secondary Outcome:

    Information By: National Institutes of Health Clinical Center (CC)

    Dates:
    Date Received: January 26, 2013
    Date Started: December 11, 2012
    Date Completion:
    Last Updated: May 12, 2017
    Last Verified: July 23, 2015