Functional neurological disorder (FND) is a common neurological presentation and can be associated with high disability, high healthcare costs and difficulty accessing treatment. Effective treatments are still being established. A feasibility study evaluating eye movement desensitisation and reprocessing (EMDR) therapy as a treatment for FND (MODIFI) demonstrated positive outcomes. The experiences of EMDR for people with FND have not been previously reported.

We aimed to explore the experiences of participants who had completed EMDR therapy in the MODIFI trial.

Participants who completed EMDR therapy in MODIFI were invited to take part in semi-structured interviews on completion of the trial. Eleven participants consented to take part and were interviewed. Interviews were analysed with reflexive thematic analysis.

Analysis was organised into four main domains: (a) expectations before the trial; (b) preparedness for EMDR; (c) mysterious but unique journey and (d) it was hard, but worth it – ‘a rewarding challenge’. Within these domains, we identified ten themes.

Participants reported limited understanding of why or how EMDR might be helpful, but were still motivated to take part. Participants expressed that they had felt anxious about focusing on memories of past experiences. However, they described feeling safe and in control in the therapy, despite it being difficult at times. Overall, participants reported positive effects, and that perceived costs were worthwhile. These results add further support that a full-scale trial evaluating FND-focused EMDR is justified.

Childhood trauma is common in functional motor disorder (FMD), but it is unclear whether specific trauma dimensions are differentially linked to symptom burden, and whether depression, anxiety, or multimorbidity can mediate these associations.

We conducted a cross-sectional case–control study including 322 patients with clinically definite FMD and 215 neurologically healthy controls, balanced with respect to age and sex. Six outcomes – motor symptom severity, cognitive complaints, depression, anxiety, fatigue, and pain – were jointly modeled using Bayesian multivariate regression with Childhood Trauma Questionnaire subscales as predictors. Bayesian structural equation modeling tested mediation by depression, anxiety, and multimorbidity.

In FMD, emotional abuse was the most consistent trauma correlate, associated with higher depression (β = 0.37, 95% CrI 0.22–0.51), anxiety (β = 0.32, 95% CrI 0.16–0.47), cognitive complaints (β = 0.27, 95% CrI 0.11–0.42), fatigue (β = 0.17, 95% CrI 0.03–0.32), and motor symptom severity (β = 0.15, 95% CrI 0.04–0.25). Mediation analyses indicated that affective symptoms fully accounted for trauma–symptom associations (indirect effect β = 0.42, 95% CrI 0.27–0.56). Multimorbidity was associated with more severe affective symptoms (β = 0.24, 95% CrI 0.12–0.37) and FMD symptoms (β = 0.24, 95% CrI 0.07–0.42) but did not mediate trauma–symptom relationships.

Emotional abuse is a key developmental risk factor for FMD, with its effects on symptom severity mediated by depression and anxiety. Multimorbidity increases symptom burden but is not a primary pathway linking trauma to FMD. Findings support routine trauma and affective symptom screening in FMD and targeted psychotherapeutic interventions.

Functional neurological disorder (FND), previously known as conversion disorder, is common and often results in substantial distress and disability. Previous research lacks large sample sizes and clinical surveys are most commonly derived from neurological settings, limiting our understanding of the disorder and its associations in other contexts. We sought to address this by analysing a large anonymised electronic psychiatric health record dataset.

Data were obtained from 322 patients in the South London and Maudsley NHS Foundation Trust (SLaM) who had an ICD-10 diagnosis of motor FND (mFND) (limb weakness or disorders of movement or gait) between 1 January 2006 and 31 December 2016. Data were collected on a range of socio-demographic and clinical factors and compared to 644 psychiatric control patients from the same register.

Weakness was the most commonly occurring functional symptom. mFND patients were more likely to be female, British, married, employed pre-morbidly, to have a carer and a physical health condition, but less likely to have had an inpatient psychiatric admission or to receive benefits. No differences in self-reported sexual or physical abuse rates were observed between groups, although mFND patients were more likely to experience life events linked to inter-personal difficulties.

mFND patients have distinct demographic characteristics compared with psychiatric controls. Experiences of abuse appear to be equally prevalent across psychiatric patient groups. This study establishes the socio-demographic and life experience profile of this understudied patient group and may be used to guide future therapeutic interventions designed specifically for mFND.