{
  "abstract": "Objectives Multidisciplinary team management is an effective approach for assessing, diagnosing and providing support for patients with functional symptoms. 1 These patients often present repeatedly in acute pediatric care settings, including inpatient admissions, without improvement until properly diagnosed and provided with a structured management plan devised by a multidisciplinary team, with paediatric psychology playing a central role. The purpose of these meetings was to ensure that all relevant referring specialties had the opportunity to discuss their cases, assess patient progress, and determine any additional actions needed by the referring clinician before the Paediatric Psychology team accepts the referral for further evaluation.Methods A fixed online biweekly MDT meeting schedule was circulated to all pertinent paediatric specialties, inviting them to discuss any patients suspected of having functional symptoms. Attendees included the mental health lead of the trust, a clinical psychologist and mental health nurse from the paediatric psychology team, and a general paediatric liaison consultant for functional neurological disorders (FND). Participation was open, leading to variable attendance numbers. Discussions focused on cases already referred to psychology to evaluate progress and new cases to assess referral suitability and identify if any further input required from medical specialists. After acceptance into psychology case management and treatment initiation, patients were discharged from the discussion.Results Over six months, 21 patients aged 8 to 16 were referred and deemed appropriate for discussion and evaluation. The male-to-female ratio was 1:1.3, potentially skewed by the small referral count, contrasting with the higher usual incidence in females. 2 The majority of referrals (66.6%, n=14) came from general paediatrics, while the remainder originated from various subspecialties. Functional neurological disorders, including non-epileptic seizures and atypical limb movements, were observed in 7 patients (33.3%). Functional gastrointestinal issues, such as globus sensation, functional dyspepsia, abdominal pain, and rumination syndrome, were reported in 23% (n=5) cases.Noncompliance with other diagnosed medical conditions leading to symptom exacerbation and inpatient monitoring prompted referrals for 19% (n=4). Notably, there was a substantial reduction in inpatient or emergency department visit following the initial family assessment, particularly for patients with FND.Conclusion Regular MDT meetings involving referring and psychology liaison team members significantly enhanced the timeliness of initial assessments by the psychology team, accelerating treatment when necessary. Despite being a biweekly meeting, its impact was profound, underscoring the importance of consistent communication between medical and psychology teams to expedite the evaluation and treatment of patients with functional symptoms, an essential step toward early recovery.References Demartini B, Batla A, Petrochilos P, Fisher L, Edwards MJ, Joyce E. Multidisciplinary treatment for functional neurological symptoms: a prospective study. J Neurol. 2014 Dec;261(12):2370-7. doi: 10.1007/s00415-014-7495-4. Epub 2014 Sep 20. PMID: 25239392; PMCID: PMC4242999.Kenneith Yong, Richard F. M. Chin, Jay Shetty, Kirsty Hogg, Kieran Burgess, Max Lindsay, Ailsa McLellan, Jon Stone, Krishnaraya KamathTallur, the Edinburgh Paediatric FND Study Group. Functional neurological disorder in children and young people: Incidence, clinical features, and prognosis.",
  "authors": [
    {
      "affiliations": [
        "Leicester Royal Infirmary"
      ],
      "name": "Birendra Rai"
    },
    {
      "affiliations": [
        "Leicester Royal Infirmary"
      ],
      "name": "Kelechukwu Ayeni"
    },
    {
      "affiliations": [
        "Leicester Royal Infirmary"
      ],
      "name": "Vanessa Berryman"
    },
    {
      "affiliations": [
        "Leicester Royal Infirmary"
      ],
      "name": "Louise Brittenden"
    },
    {
      "affiliations": [
        "Leicester Royal Infirmary"
      ],
      "name": "Samantha J Jones"
    }
  ],
  "title": "8072 Impact of regular virtual paediatric psychosocial multidisciplinary MDT on patients’ progress from referral to initiation of treatment",
  "uid": "af280035-35ab-57a3-a81b-8140a6ad3f63"
}