General Psychiatry

Rise in Functional Movement Disorders During the COVID-19 Pandemic

Amit Akirov, MD
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Tremor of the extremities in various diseases. Patient care concept. A patient with Parkinson’s disease has trembling hands.
This case-series described the effect of the COVID-19 pandemic on the incidence of movement disorders in children and adults.

The incidence of functional (psychogenic) movement disorders in both the pediatric and adult age groups has increased during the COVID-19 pandemic, according to study results published in Neurology Clinical Practice.

Functional (psychogenic) movement disorders are characterized by abnormal movements that are thought to be a manifestation of a dysfunctional manner of coping with underlying psychological stressors.

The current case-series described the effect of the COVID-19 pandemic on the incidence of movement disorders in children and adults.

Using the electronic medical records of all patients who were evaluated at the movement disorders clinics at the Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, between March 1 and October 30, 2020 and during the same period in 2019, all patients with functional or psychogenic movement disorders were identified.

From March 1 to October 30, 2020, a total of 45 of 550 (8.2%) new patients evaluated at the movement disorders centers received a new diagnosis of functional movement disorder, including 12 children and 33 adults. This represents a 60.1% increase (90.1% in pediatric cohort, 50.9% in adult cohort) in the incidence compared with the same period in 2019, during which only 34 of 665 (5.1%) new patients evaluated were diagnosed with functional movement disorder (8 children, 26 adults).

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Most patients diagnosed with functional movement disorders during the COVID-19 pandemic were women or girls (75.6%). More than 60% had a prior psychiatric diagnosis, and the most common pre-existing psychiatric diagnoses were depression (18 patients) and anxiety (16 patients). Clear precipitating factors were identified in approximately half (48.9%) of patients.

Tremor was the most common presenting phenomenology, reported in 24 patients (53.5%), followed by dystonia (31.1%), myoclonus (17.8%), tics (8.9%), and stereotypy (8.9%).

The study had several limitations, including potential recall and selection bias, and the cross-sectional design.

“[T]he current rise in incidence of [functional (psychogenic) movement disorders] may support the role of psychological stressors related to social isolation, financial strain and other pandemic-related burdens within this disorder,” concluded the study researchers.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Hull M, Parnes M, Jankovic J. Increased incidence of functional (psychogenic) movement disorders in children and adults amidst the COVID-19 pandemic: a cross-sectional study. Neurol Clin Pract. Published online April 14, 2021. doi:CPJ.0000000000001082

This article originally appeared on Neurology Advisor