Objective: To review the historical evolution of hysteria to Functional Movement Disorders (FND), and Functional Movement Disorders (FMD), and to investigate the systemic and scientific factors influencing this transition.

Background: Female neuropsychiatric distress was attributed to uterine pathology for nearly four millennia, underpinning the concept of hysteria. Movement abnormalities associated to it are now classified as FMD.

Method: A narrative literature review was conducted using PubMed, Google Scholar and Internet Archive to identify historical medical texts. Clinical symptoms were examined in historical texts and changes in diagnostic classification and female representation were examined from DSM-I to DSM-5.

Results: In ancient and medieval times, abnormal gait, seizure-like, tremor, and pain were reported as physical manifestations of a womb disease even as brain disorders became better understood (1-5). Until 1980, “hysterical neurosis” was still used to describe FND including a variety of FMD (6-7). Female representation in DSM committees increased progressively rising from zero in DSM-I, to 30-35% in DSM-III onward (6-8). This prompted reconsideration of historically gendered interpretations of hysteria that directly improved the classification of FMD. Recent findings suggest an underlying multinetwork brain dysfunction in FMD resulting from a dysregulation within the limbic, sensorimotor, agency, and salience networks (9).

Conclusion: The transition from hysteria to FMD reflects how structural gender equity in research increases scientific accuracy by neutralizing gender bias. Future studies should assess how physical, neurological and psychosocial triggers affect these networks differently in men and women to propose more personalized therapies.

References: 1. Lopes HT, Pereira RGG. The Gynecological Papyrus Kahun. In: IntechOpen. 2021. doi:10.5772/intechopen.95311.

2. Hanson AE. Hippocrates: “Diseases of Women 1.” Signs. 1975;1(2):567–584.

3. Abū Bakr Muhammad ibn Zakariyyā al‑Rāzī. Hādhā Kitāb al-Ḥāwī al-Kabīr. ca. 900 AD. Available from: http://archive.org/details/McGillLibrary-108941-466

4. Aretaeus of Cappadocia. Aretaeus the Cappadocian on mental illness. Compr Psychiatry. 1986 Mar;27(2):171–179. doi:10.1016/0010-440X(86)90026-X.

5. Avicenna. Kitāb al-Qānūn fī al-Ṭibb (Canon of Medicine). 980–1037. Available from: http://archive.org/details/4770566_1.med.yale.edu

6. Diagnostic and Statistical Manual of Mental Disorders DSM-I. Washington (DC): American Psychiatric Association; 1952. Available from: http://archive.org/details/dsm-1

7. Diagnostic and Statistical Manual of Mental Disorders DSM-III. Washington (DC): American Psychiatric Association; 1987. 622 p. Available from: http://archive.org/details/diagnosticstatis0000unse_j7a2

8. Diagnostic and Statistical Manual of Mental Disorders DSM-5. Washington (DC): American Psychiatric Association; 2013. Available from: http://archive.org/details/dsm-5_202110

9. Perez DL, Dworetzky BA, Dickerson BC, Leung L, Cohn R, Baslet G, et al. An integrative neurocircuit perspective on psychogenic nonepileptic seizures and functional movement disorders: neural functional unawareness. Clin EEG Neurosci. 2015 Jan;46(1):4–15. doi:10.1177/1550059414555905 PubMed PMID: 25432161; PubMed Central PMCID: PMC4363170.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/from-hysteria-to-functional-movement-disorders-the-evolution-of-a-concept/