Objective: To assess if the phenotype or age at onset of Functional movement Disorders (FMD) vary as a function of presence of a perfectionist personality trait or history of abuse.

Background: FMD are involuntary movement disorders not due to a known medical disorder and thought to be psychologically mediated[1]. FMD can present as any type of hypokinetic or hyperkinetic abnormal movements[2]. Previous studies have analyzed the correlation between different types of conversion disorder (functional movement disorder, non-epileptic seizures…) and personality trait or history of childhood abuse[3]. However, there is no data on a possible correlation between specific phenotypes or age at onset of FMD and personality trait or history of child abuse. Detecting such a potential association might help guide future research into the pathophysiology of FMD.

Method: Charts of all patients diagnosed with FMD by a movement disorder specialist using the commonly accepted clinical diagnostic criteria for FMD[4] seen at a tertiary center between January 1, 2011 and December 31, 2019 were reviewed.  Data collected were sex, age at the onset of the first FMD, phenotype of the first predominant FMD, history of perfectionist personality trait and history of childhood abuse (physical, sexual, emotional, or neglect).  Statistical analyses were performed using Chi-square test, fisher’s exact test, two-sample t test or Wilcoxon rank sum test as appropriate.

Results: 68 patients with FMD were identified from which 12 were excluded for incomplete documentation.56 patients were included in the analysis, 43(76.8%) were women, with average age at onset 41.5y range 13-74.4). The most frequent predominant initial FMD phenotypes were tremor(42.9%), dystonia(21.4%) and gait disorders(23.2%). A perfectionist personality trait was reported in 30(53.6%) patients and history of abuse in 27(48.2%). There was no significant correlation between each of the primary FMD phenotype and perfectionist personality trait or history of abuse. There was also no correlation between the age at symptoms onset and perfectionist personality trait or history of abuse.

Conclusion: We could not demonstrate a significant correlation between FMD phenotype or age at onset and perfectionist personality trait or history of abuse. This could be limited by our small sample. Larger studies are needed to confirm these results.

References: 1. American Psychiatric Association, Task Force on DSM-IV. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, fourth ed., American Psychiatric Association, Washington, DC, 2000. 2. Hallett M. Physiology of psychogenic movement disorders, J. Clin. Neurosci. 17 (8) (2010) 959–965. 3. Ekanayake V, Kranick S, LaFaver K, Naz A, Frank Webb A, LaFrance WC Jr, Hallett M, Voon V. Personality traits in psychogenic nonepileptic seizures (PNES) and psychogenic movement disorder (PMD): Neuroticism and perfectionism. J Psychosom Res. 2017 Jun;97:23-29. 4. Espay AJ, Lang AE. Phenotype-specific diagnosis of functional (psychogenic) movement disorders. Curr Neurol Neurosci Rep. 2015 Jun;15(6):32.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/are-functional-movement-disorder-phenotypes-or-age-at-onset-correlated-with-perfectionist-personality-trait-or-history-of-abuse/