{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:35:58Z","timestamp":1791462958378,"version":"4.3.4"},"reference-count":119,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Functional Neurological Disorder (FND) encompasses a spectrum of symptoms\u2014including motor, cognitive, and seizure-like manifestations\u2014that are not fully explained by structural neurological disease. Accumulating evidence suggests that comorbid psychiatric and somatic conditions significantly influence the clinical course, diagnostic complexity, and treatment response in FND. Objective: This study systematically explores psychiatric and medical comorbidities across major FND subtypes\u2014Functional Cognitive Disorder (FCD), Functional Movement Disorder (FMD), and Psychogenic Non-Epileptic Seizures (PNES)\u2014with an emphasis on subtype-specific patterns and shared vulnerabilities. Methods: We conducted a narrative review of the published literature, guided by systematic principles for transparency, covering both foundational and contemporary sources to examine comorbid conditions in patients with FCD, FMD, PNES, PPPD and general (mixed) FND populations. Relevant studies were identified through structured research and included based on methodological rigor and detailed reporting of comorbidities (PRISMA). Extracted data were organized by subtype and comorbidity type (psychiatric or medical\/somatic). Results: Across all FND subtypes, high rates of psychiatric comorbidities were observed, particularly depression, anxiety, PTSD, and dissociative symptoms. FCD was predominantly associated with internalizing symptoms, affective misattribution, and heightened cognitive self-monitoring. FMD demonstrated strong links with trauma, emotional dysregulation, and personality vulnerabilities. PNES was characterized by the highest burden of psychiatric illness, with complex trauma histories and dissociation frequently reported. Somatic comorbidities\u2014such as fibromyalgia, chronic pain, irritable bowel syndrome, and fatigue\u2014were also prevalent across all subtypes, reflecting overlapping mechanisms involving interoception, central sensitization, and functional symptom migration. Conclusions: Comorbid psychiatric and medical conditions are integral to understanding the presentation and management of FND. Subtype-specific patterns underscore the need for individualized diagnostic and therapeutic approaches, while the shared biopsychosocial mechanisms suggest benefits of integrated care models across the FND spectrum.<\/jats:p>","DOI":"10.3390\/life15081322","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T13:18:14Z","timestamp":1755695894000},"page":"1322","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comorbidities Across Functional Neurological Disorder Subtypes: A Comprehensive Narrative Synthesis"],"prefix":"10.3390","volume":"15","author":[{"given":"Ioannis","family":"Mavroudis","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Leeds Teaching Hospital, NHS Trust, Leeds LS17 7HY, UK"},{"name":"Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK"},{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Academy of Romanian Scientists, 050085 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Franekova","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5617-0346","authenticated-orcid":false,"given":"Foivos","family":"Petridis","sequence":"additional","affiliation":[{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alin","family":"Ciob\u00eeca","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Biology, \u201cAlexandru Ioan Cuza\u201d University of Iasi, 700506 Iasi, Romania"},{"name":"CENEMED Platform for Interdisciplinary Research, University of Medicine and Pharmacy \u201cGrigore T. Pop\u201d, 700115 Iasi, Romania"},{"name":"\u201cOlga Necrasov\u201d Center, Department of Biomedical Research, Romanian Academy, 010071 Iasi, Romania"},{"name":"\u201cIoan Haulica\u201d Institute, Apollonia University, 700511 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u0103sc\u0103lescu","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Biology, \u201cAlexandru Ioan Cuza\u201d University of Iasi, 700506 Iasi, Romania"},{"name":"\u201cIoan Haulica\u201d Institute, Apollonia University, 700511 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8244-0522","authenticated-orcid":false,"given":"Emil","family":"Anton","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Pop\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian","family":"Ilea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Pop\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios","family":"Papagiannopoulos","sequence":"additional","affiliation":[{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7319-2045","authenticated-orcid":false,"given":"Dimitrios","family":"Kazis","sequence":"additional","affiliation":[{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.7861\/clinmed.2020-0987","article-title":"A practical review of functional neurological disorder (FND) for the general physician","volume":"21","author":"Bennett","year":"2021","journal-title":"Clin. 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