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.


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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).

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