Shared Individual Formulation Therapy (SIFT): an open-label trial of a new therapy accommodating patient heterogeneity in functional neurological disorder
Background Functional Neurological Disorder (FND) is a complex neuropsychiatric condition with a multifactorial aetiology. The heterogeneity of patients with FND is rarely considered in psychotherapy trials, which may contribute to variable outcomes. Shared Individual Formulation Therapy (SIFT) is a...
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| Veröffentlicht in: | Journal of neurology 2021-12, Vol.268 (12), p.4882-4889 |
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| creator | Gutkin, M. Brown, R. J. McLean, L. Streimer, J. Kanaan, R. A. |
| description | Background
Functional Neurological Disorder (FND) is a complex neuropsychiatric condition with a multifactorial aetiology. The heterogeneity of patients with FND is rarely considered in psychotherapy trials, which may contribute to variable outcomes. Shared Individual Formulation Therapy (SIFT) is a new, brief (four session) psychotherapy that aims to accommodate heterogeneity by providing a personalised, trans-theoretical formulation of the person’s difficulties and accompanying management plan.
Methods
An open-label, prospective trial of outpatient SIFT for adults with FND was conducted, using health-related quality of life (SF-12) as the principal outcome measure, with secondary measures of mental health, dissociation, health care use and attitude to the FND diagnosis. Measures were collected at baseline, end of treatment and 6- and 12-month follow-ups.
Results
Twenty-nine participants with various FND symptoms enrolled. Twenty-four completed all four sessions and 25 completed follow-up measures at 12 months. SF-12 scores improved significantly at end of treatment and were sustained throughout follow-up with moderate effect sizes (0.39–0.47; all
p
|
| doi_str_mv | 10.1007/s00415-021-10797-y |
| format | Article |
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Functional Neurological Disorder (FND) is a complex neuropsychiatric condition with a multifactorial aetiology. The heterogeneity of patients with FND is rarely considered in psychotherapy trials, which may contribute to variable outcomes. Shared Individual Formulation Therapy (SIFT) is a new, brief (four session) psychotherapy that aims to accommodate heterogeneity by providing a personalised, trans-theoretical formulation of the person’s difficulties and accompanying management plan.
Methods
An open-label, prospective trial of outpatient SIFT for adults with FND was conducted, using health-related quality of life (SF-12) as the principal outcome measure, with secondary measures of mental health, dissociation, health care use and attitude to the FND diagnosis. Measures were collected at baseline, end of treatment and 6- and 12-month follow-ups.
Results
Twenty-nine participants with various FND symptoms enrolled. Twenty-four completed all four sessions and 25 completed follow-up measures at 12 months. SF-12 scores improved significantly at end of treatment and were sustained throughout follow-up with moderate effect sizes (0.39–0.47; all
p
< 0.001). Most secondary outcomes also improved significantly at all time points. The intervention was highly acceptable and tolerable to patients and perceived as beneficial.
Conclusion
This trial provides preliminary evidence for initial and sustained benefit from SIFT for adults with FND. Further study is needed to validate these findings.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-021-10797-y</identifier><identifier>PMID: 34537867</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Clinical trials ; Health care ; Humans ; Medicine ; Medicine & Public Health ; Mental disorders ; Nervous System Diseases - therapy ; Neurological disorders ; Neurology ; Neuroradiology ; Neurosciences ; Original Communication ; Patients ; Prospective Studies ; Psychotherapy ; Quality of Life</subject><ispartof>Journal of neurology, 2021-12, Vol.268 (12), p.4882-4889</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-9448fc2f7ec3d2a5cd53b7692a0a681bc34309a282c3391a8452997129877ea43</citedby><cites>FETCH-LOGICAL-c419t-9448fc2f7ec3d2a5cd53b7692a0a681bc34309a282c3391a8452997129877ea43</cites><orcidid>0000-0003-1700-7172</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-021-10797-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-021-10797-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34537867$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gutkin, M.</creatorcontrib><creatorcontrib>Brown, R. J.</creatorcontrib><creatorcontrib>McLean, L.</creatorcontrib><creatorcontrib>Streimer, J.</creatorcontrib><creatorcontrib>Kanaan, R. A.</creatorcontrib><title>Shared Individual Formulation Therapy (SIFT): an open-label trial of a new therapy accommodating patient heterogeneity in functional neurological disorder</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Background
Functional Neurological Disorder (FND) is a complex neuropsychiatric condition with a multifactorial aetiology. The heterogeneity of patients with FND is rarely considered in psychotherapy trials, which may contribute to variable outcomes. Shared Individual Formulation Therapy (SIFT) is a new, brief (four session) psychotherapy that aims to accommodate heterogeneity by providing a personalised, trans-theoretical formulation of the person’s difficulties and accompanying management plan.
Methods
An open-label, prospective trial of outpatient SIFT for adults with FND was conducted, using health-related quality of life (SF-12) as the principal outcome measure, with secondary measures of mental health, dissociation, health care use and attitude to the FND diagnosis. Measures were collected at baseline, end of treatment and 6- and 12-month follow-ups.
Results
Twenty-nine participants with various FND symptoms enrolled. Twenty-four completed all four sessions and 25 completed follow-up measures at 12 months. SF-12 scores improved significantly at end of treatment and were sustained throughout follow-up with moderate effect sizes (0.39–0.47; all
p
< 0.001). Most secondary outcomes also improved significantly at all time points. The intervention was highly acceptable and tolerable to patients and perceived as beneficial.
Conclusion
This trial provides preliminary evidence for initial and sustained benefit from SIFT for adults with FND. Further study is needed to validate these findings.</description><subject>Adult</subject><subject>Clinical trials</subject><subject>Health care</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental disorders</subject><subject>Nervous System Diseases - therapy</subject><subject>Neurological disorders</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Psychotherapy</subject><subject>Quality of Life</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc9uEzEQhy0EomnhBTggS1zag6n_xmtuqCIQqVIPDeeV451NXO3ai70L2lfhaXGaAFIPPY2s-eY3Gn8IvWP0I6NUX2dKJVOEckYY1UaT-QVaMCk4YVKZl2hBhaRECSXP0HnOD5TSqjReozMhldDVUi_Q7_u9TdDgdWj8T99MtsOrmPqps6OPAW_2kOww48v79Wpz9QnbgOMAgXR2Cx0eky98bLHFAX7h8QRb52Lfx6ZEhB0eSoEw4j2MkOIOAvhxxj7gdgrusKREBJhS7OLOu_JofI6pgfQGvWptl-HtqV6g76svm5tv5Pbu6_rm8y1xkpmRGCmr1vFWgxMNt8o1Smz10nBL7bJiWyekoMbyijshDLPlC7gxmnFTaQ1Wigt0ecwdUvwxQR7r3mcHXWcDxCnXXGmpRcW1KuiHJ-hDnFK54EAZVmm1fKT4kXIp5pygrYfke5vmmtH6YK4-mquLufrRXD2Xofen6GnbQ_Nv5K-qAogjkEsr7CD93_1M7B9d-6XG</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Gutkin, M.</creator><creator>Brown, R. 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A.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1700-7172</orcidid></search><sort><creationdate>20211201</creationdate><title>Shared Individual Formulation Therapy (SIFT): an open-label trial of a new therapy accommodating patient heterogeneity in functional neurological disorder</title><author>Gutkin, M. ; Brown, R. J. ; McLean, L. ; Streimer, J. ; Kanaan, R. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-9448fc2f7ec3d2a5cd53b7692a0a681bc34309a282c3391a8452997129877ea43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Clinical trials</topic><topic>Health care</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental disorders</topic><topic>Nervous System Diseases - therapy</topic><topic>Neurological disorders</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Original Communication</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Psychotherapy</topic><topic>Quality of Life</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gutkin, M.</creatorcontrib><creatorcontrib>Brown, R. J.</creatorcontrib><creatorcontrib>McLean, L.</creatorcontrib><creatorcontrib>Streimer, J.</creatorcontrib><creatorcontrib>Kanaan, R. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gutkin, M.</au><au>Brown, R. J.</au><au>McLean, L.</au><au>Streimer, J.</au><au>Kanaan, R. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Shared Individual Formulation Therapy (SIFT): an open-label trial of a new therapy accommodating patient heterogeneity in functional neurological disorder</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>268</volume><issue>12</issue><spage>4882</spage><epage>4889</epage><pages>4882-4889</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><abstract>Background
Functional Neurological Disorder (FND) is a complex neuropsychiatric condition with a multifactorial aetiology. The heterogeneity of patients with FND is rarely considered in psychotherapy trials, which may contribute to variable outcomes. Shared Individual Formulation Therapy (SIFT) is a new, brief (four session) psychotherapy that aims to accommodate heterogeneity by providing a personalised, trans-theoretical formulation of the person’s difficulties and accompanying management plan.
Methods
An open-label, prospective trial of outpatient SIFT for adults with FND was conducted, using health-related quality of life (SF-12) as the principal outcome measure, with secondary measures of mental health, dissociation, health care use and attitude to the FND diagnosis. Measures were collected at baseline, end of treatment and 6- and 12-month follow-ups.
Results
Twenty-nine participants with various FND symptoms enrolled. Twenty-four completed all four sessions and 25 completed follow-up measures at 12 months. SF-12 scores improved significantly at end of treatment and were sustained throughout follow-up with moderate effect sizes (0.39–0.47; all
p
< 0.001). Most secondary outcomes also improved significantly at all time points. The intervention was highly acceptable and tolerable to patients and perceived as beneficial.
Conclusion
This trial provides preliminary evidence for initial and sustained benefit from SIFT for adults with FND. Further study is needed to validate these findings.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34537867</pmid><doi>10.1007/s00415-021-10797-y</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1700-7172</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Clinical trials Health care Humans Medicine Medicine & Public Health Mental disorders Nervous System Diseases - therapy Neurological disorders Neurology Neuroradiology Neurosciences Original Communication Patients Prospective Studies Psychotherapy Quality of Life |
| title | Shared Individual Formulation Therapy (SIFT): an open-label trial of a new therapy accommodating patient heterogeneity in functional neurological disorder |
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