Summary
Definition
History and exam
Key diagnostic factors
- unconventional behaviour during history
- emotional processing problems
- recent life stressors
- remote life stressors
- multiple illness behaviours
- unusual neurological deficits
- give-way weakness
- inconsistent examination findings
- false sensory findings
- distractible symptoms
- inconsistent paralysis
- generalised seizure-like motor movements without loss of awareness
- bizarre movements
- gait disorders
- functional (psychogenic) movement disorders
Other diagnostic factors
- cognitive complaints
- Hoover's sign
- speech disturbance
- swallowing disturbance
- pseudoclonus
- convergence spasm
Risk factors
- history of sexual or physical abuse
- history of unstable childhood
- history of trauma-related disorders
- female sex
- alexithymia
- neuroticism
- previously poor doctor-patient relationships
Diagnostic investigations
Investigations to consider
- comprehensive neuropsychological testing
- standardised personality testing
- focused symptom inventories
Treatment algorithm
Contributors
Authors

Associate Professor of Psychiatry
Mayo Clinic
Scottsdale
AZ
Disclosures
CS is an author of a number of references cited in this topic.

Professor of Neurology
Mayo Clinic
Scottsdale
AZ
Disclosures
EDD declares that she has no competing interests.

Associate Professor of Neurology
Mayo Clinic
Scottsdale
AZ
Disclosures
KHN declares that she has no competing interests.

Professor of Psychology
Mayo Clinic
Scottsdale
AZ
Disclosures
DL declares that she has no competing interests.
Peer reviewers
Professor of Liaison Psychiatry
Director
Leeds Institute of Health Sciences
Leeds
UK
Disclosures
AH declares that he has no competing interests.
Assistant Clinical Professor
Department of Psychiatry and Behavioral Sciences
Department of Internal Medicine
University of California
Davis
Sacramento
CA
Disclosures
GLX may receive royalties as a co-editor of a book entitled Lippincott's Primary Care Psychiatry. He has no other competing interests.
Professor of Psychiatry and Emergency Medicine
Yale School of Medicine
Yale-New Haven Hospital
New Haven
CT
Disclosures
SP declares that he has no competing interests.
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