Who is referred to neurology clinics?—The diagnoses made in 3781 new patients
Introduction
Information on the nature and relative frequency of diagnoses made in referrals to neurology outpatient clinics is an important guide to priorities in services, teaching and research. Published studies suffer several types of limitations [1], [2], [3], [4], [5], [6], [7]. Several have been of single neurologist's practice [1], [2], [6], [7], others have had small samples [3], [5], or have been lacking in diagnostic detail [4].
In order to provide better information we set out to: (a) describe in detail the nature and relative frequency of neurological diagnoses received by a large sample of new referrals to NHS neurology out patient clinics throughout Scotland, and (b) the demographic characteristics of the patients in each diagnostic category.
Section snippets
Methods
The data reported here were collected by the Scottish Neurological Symptoms Study. This was a prospective, multi-centre, cohort study of neurology outpatients in Scotland, UK. Ethical approval for the study was granted by a Multi-centre Research Ethics Committee MREC.
Recruitment
Between 16/12/2002 and 26/02/2004, 4299 new patients attended the specified clinics. Of these, 138 were excluded (80 were cognitively impaired, 17 had language difficulties, 15 were considered by the doctor as unsuitable for the study, 12 were too physically disabled or ill, in 10 no reason was recorded, 3 had severe behavioural problems, and 1 was too young). Of the remaining 4161 patients 269 refused to participate, 101 did not complete the assessment and 10 neurologist diagnoses were not
Discussion
This study provides detailed data on the neurological diagnoses made by a representative sample of neurologists in 3781 new patients (36) referred from across Scotland. Whilst it was not surprising to find that headache was the commonest category of diagnosis made, it was striking that the second commonest category was patients with functional or psychological diagnoses.
Conflict of interest
None.
Funding
Clinical Research Audit Group (CRAG) NHS Scotland and the Chief Scientist Office of the Department of Health of the Scottish Government.
Acknowledgments
we would like to thank all the neurologists and general practitioners who took part in this study; S Tennant, L Alder, J Sim, M Selkirk, D McConachie—the researchers who administered the questionnaires.
References (16)
- et al.
Medically unexplained symptoms: an epidemiological study in seven specialities
J Psychosom Res
(2001) - et al.
Somatoform disorders among first-time referrals to a neurology service
Psychosomatics
(2005) An analysis of 7836 successive new outpatient referrals
J Neurol Neurosurg Psychiatry
(1989)Neurology in Gloucestershire: the clinical workload of an English neurologist
J Neurol Neurosurg Psychiatry
(1989)- et al.
A record of patient encounters in neurological practice in the United Kingdom
J Neurol Neurosurg Psychiatry
(1989) UK audit of the care of common neurological disorders
(1991)- et al.
General Practice referrals to a department of neurology
J R Coll Physicians
(1996) Neurology training in the United Kingdom: a diagnostic analysis of over 5000 patients
J Neurol
(2005)
Cited by (354)
Anger regulation in patients with functional neurological disorder: A systematic review
2024, General Hospital PsychiatryForearm bisection task suggests an alteration in body schema in patients with functional movement disorders (motor conversion disorders)
2024, Journal of Psychosomatic ResearchAlexithymia and facial emotion recognition in patients with functional neurological disorder
2024, Clinical Neurology and NeurosurgeryCorrespondence: Inaccurate reference leads to tripling of reported FND prevalence
2024, NeuroImage: Clinical