Clinical trial NCT05746637: The Complexity of the Diagnostic Pathway of Children With a Functional Neurological Symptomatology Disorder
Official title: Qualitative and Quantitative Study of the Complexity of the Diagnostic Pathway of Children With a Functional Neurological Symptomatology Disorder
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Conversion Disorder in Children
Keywords: adolescents
functional neurological symptom disorder
children
qualitative study
Lead sponsor: University Hospital, Clermont-Ferrand
Sponsor class: OTHER
First posted: 2023-02-28
Enrollment: 60
Sex: ALL
Minimum age (years): 6
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Our population will be a clinical population, made up of children and adolescents aged 6 to 18 years followed at the Clermont-Ferrand University Hospital for TSNF, their parents, and the health professionals who care for them.

Before the age of 6, it is not easy to talk about oneself and the collection of information is generally done through the parents. After the age of 6, children are able to describe their experience, which allows us to collect their experiences and those of their parents separately. Adolescents between 16 and 18 years of age are often still followed by pediatric teams, and mostly followed by child psychiatry, which justifies the broad cut-off of 18 years.

Brief summary: The goal of this qualitative and quantitative cross-sectional observational study is to describe the complexity of the diagnostic pathway for Functional Neurological Symptomatology Disorder (TSNF) in children and adolescents based on the experience of the different protagonists of care (parents, adolescents, caregivers).

The main question\[s\] it aims to answer are:

* How do the various stakeholders experiences the care pathway for children and adolescents with a diagnosis of TSNF
* What are their expectations regarding the diagnosis and management of TSNF Participants will be enrolled in interviews in which they will describe their experience. Parents will also answer a lifestyle questionnaire.

Detailed description: Conversion Disorder (CD) or Functional Neurological Symptomatology Disorder (FNSD) is a pathology characterized by the occurrence of non-simulated physical symptoms of neurological appearance in the absence of underlying organic pathology.

The hyperspecialization of medicine makes the therapeutic approach to FNSD very complex for several reasons:

* Pediatric health professionals are trained to diagnose and treat physical disorders and are at a loss when it comes to psychological disorders
* Physicians often increase the number of complementary tests before making a diagnosis of FNSD, for fear of missing a serious or urgent pathology
* Psychiatric diagnosis is a diagnosis of exclusion, and TSNF is therefore often evoked at the end of the treatment, which leads to wandering in the patient's care This delay in diagnosis does not allow patients to receive appropriate care and the consequences can be serious.

The objective of this mixed qualitative and quantitative study is to study the complexity of the care pathway of patients aged 6 to 18 years with a diagnosis of TSNF, as well as their parents and the health professionals who have taken care of them. The collection of their experience will be done by means of semi-structured interviews which will then be analyzed according to the Interpretative Phenomenological Analysis.

Eligibility criteria: Inclusion Criteria:

* Patients

  * Child or adolescent, boy or girl, aged 6 to 17 years inclusive, treated at the Clermont-Ferrand University Hospital for a conversion disorder diagnosed by a psychiatrist during the past year
  * Presence or not of a follow-up in child psychiatry after the diagnosis
  * Agreement of the legal representatives for participation in the study.
  * Affiliation to a Social Security system.
* Parents / legal representatives

  o Adult subject, parent or legal representative of a child or adolescent meeting the above-mentioned inclusion criteria and participating in the study
* Health professionals

  o Person affiliated with the Clermont-Ferrand University Hospital, with experience in caring for children or adolescents with a conversion disorder (pediatrician, psychiatrist, nurse, psychologist,
* For all participants

  * Able to give informed consent to participate in the research.
  * Proficiency in the French language \[NB the written language must be mastered by the parents to answer the questionnaires\].

Exclusion Criteria:

* For all participants: Present a decompensated somatic or psychiatric pathology or a disorder of vigilance compromising the realization of the research, refusal to participate in the research.

Primary outcomes:
measure: Participants' experience of the diagnostic circumstances and care pathway
timeFrame: 1 day
Secondary outcomes:
measure: Description the diversity of experiences according to each type of participant
timeFrame: 1 day
measure: Participants' expectations regarding the diagnosis and management of TSNF
timeFrame: 1 day
measure: Total duration of the diagnosis pathway
timeFrame: 1 day
measure: Total number of outpatient consultations related to TSNF
timeFrame: 1 day
measure: Total number of part-time inpatient stays
timeFrame: 1 day
measure: Total number of full-time inpatient stays in the OOH setting
timeFrame: 1 day
measure: Total length of stay in full-time OCM hospitalization
timeFrame: 1 day
measure: Presence of one or more biological or radiological additional examination from the list
timeFrame: 1 day
Other outcomes:
Locations:
city: Clermont-Ferrand
country: France
facility: CHU de Clermont-Ferrand
Study officials:
affiliation: University Hospital, Clermont-Ferrand
name: Aurore Legrand-Viskoc
role: PRINCIPAL_INVESTIGATOR
References: