Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec 13;7(2):177-181.
doi: 10.1002/mdc3.12863. eCollection 2020 Feb.

Gender as a Risk Factor for Functional Movement Disorders: The Role of Sexual Abuse

Isaiah Kletenik  1   2 , Stefan H Sillau  1 , Sanaz Attaripour Isfahani  3 , Kathrin LaFaver  4   5 , Mark Hallett  3 , Brian D Berman  1   6
Affiliations

Gender as a Risk Factor for Functional Movement Disorders: The Role of Sexual Abuse

Isaiah Kletenik et al. Mov Disord Clin Pract. .

Abstract

Background: The prevalence of functional movement disorders is 2 to 3 times higher in women than in men. Trauma and adverse life events are important risk factors for developing functional movement disorders. On a population level, rates of sexual abuse against women are higher when compared with the rates against men.

Objectives: To determine gender differences in rates of sexual abuse in functional movement disorders compared with other neurologic disorders and evaluate if the gender prevalence is influenced by higher rates of sexual abuse against women.

Methods: We performed a case-control series including 199 patients with functional movement disorders (149 women) and 95 controls (60 women). We employed chi-squared test to assess gender and sexual abuse associations and Bayes formula to condition on sexual abuse.

Results: Our analysis showed an association between sexual abuse and functional movement disorders in women (odds ratio, 4.821; 95% confidence interval, 2.089-12.070; P < 0.0001), but not men. Bayesian analysis found the functional movement disorder prevalence ratio between women and men conditional on sexual abuse to be 4.87 times the unconditioned ratio.

Conclusions: There is a statistically significant association between sexual abuse and functional movement disorders in women and a greater likelihood that women who are sexually abused will develop functional movement disorders than men who are sexually abused. Our findings suggest that the increased prevalence of functional movement disorders in women is associated, at least in part, with sexual abuse and its sequelae; however, further research is needed to explore the role of other traumatic and nontraumatic factors.

Keywords: conversion disorder; functional movement disorder; psychogenic movement disorder; sexual abuse; trauma.

PubMed Disclaimer

References

    1. Espay AJ, Aybek S, Carson A, et al. Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol 2018;75(9):1132–1141. - PMC - PubMed
    1. Stone J, Carson A, Duncan R, et al. Symptoms 'unexplained by organic disease' in 1144 new neurology out‐patients: how often does the diagnosis change at follow‐up? Brain 2009;132(Pt 10):2878–2888. - PubMed
    1. Kanaan RAA. Freud's hysteria and its legacy. Handb Clin Neurol 2016;139:37–44. - PubMed
    1. Baizabal‐Carvallo JF, Hallett M, Jankovic J. Pathogenesis and pathophysiology of functional (psychogenic) movement disorders. Neurobiol Dis 2019;127:32–44. - PubMed
    1. Ludwig L, Pasman JA, Nicholson T, et al. Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta‐analysis of case‐control studies. Lancet Psychiatry 2018;5(4):307–320. - PubMed

LinkOut - more resources