The RCPsych Article of the Month for November is from BJPsych Advances and is entitled ‘Functional cognitive disorders: identification and management’ by Norman Poole, Sarah R. Cope, Cate Bailey and Jeremy D. Isaacs.

We wanted to write an article for psychiatrists about functional cognitive disorders (FCDs) because they are not well understood but increasingly seen in memory clinics and general adult psychiatry services. Each of the authors has experience and expertise in different aspects and we all work alongside one another, so it was very easy to write and edit. The paper is modelled on one written by Nick Medford some time ago on Depersonalisation Disorder (DP). Dr Medford’s paper is easy to read but packed with useful tips and pointers to help clinicians who see DP only occasionally. We realised that BJPsych Advances is a great place to publish reviews of important but neglected clinical problems.

Clinicians normally think of the dramatic FCD cases, such as dissociative amnesia or loss of identity, but these are in fact quite rare forms of the condition. Much more common are those who report daily lapses of memory and concentration. Nobody really understands why this occurs but it is very distressing to patients and long-lasting. Understandably, patients often fear they have dementia but the clinical picture and symptoms are really quite different and the diagnosis can usually be made without the need for neuroimaging and other biomedical tests. In fact, we hope that making the diagnosis based on positive clinical signs will reduce patients’ fears and avoid the need for expensive, and potentially harmful, investigations.

The next steps are to generate clear diagnostic criteria and the paper has helped us link with other researchers interested in treating these patients. Ultimately, we aim to investigate the underlying processes involved in symptom generation and start treatment trials.

We will judge this paper a success if it helps clinicians make the diagnosis and talk to their patients about the condition with greater confidence. Given how common these problems are, pretty much every psychiatrist should know something about functional cognitive disorders.

Complimentary access has been provided to this article for a limited time: Functional cognitive disorders: identification and management

There’s more…listen to the BJPsych Advances podcast: Functional Cognitive Disorders: identification and management

RCPsych Article of the Month

Each month a paper is selected by one of the Editors of the five RCPsych Journals (The British Journal of Psychiatry (BJPsych), BJPsych Open, BJPsych Advances, BJPsych Bulletin and BJPsych International)

View the full collection here.

“I have chosen this paper because it deals with a common complaint i.e memory impairment in those who have no objective evidence same. This paper, however, goes beyond this to deal with other presentations and causes. The paper is very clear and provides a valuable introduction to a clinical problem that is rarely written about”.

Patricia Casey, Editor-in-Chief BJPsych Advances

Find out more about the RCPsych Publications by visiting the RCPsych Hub!