{"id":3869,"date":"2024-04-18T10:00:20","date_gmt":"2024-04-18T09:00:20","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-humanities\/?p=3869"},"modified":"2024-04-05T10:00:55","modified_gmt":"2024-04-05T09:00:55","slug":"meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-humanities\/2024\/04\/18\/meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services\/","title":{"rendered":"Meaning and Role of Functional-Organic Distinction: A Study of Clinicians in Psychiatry and Neurology Services"},"content":{"rendered":"<p><strong>Article Summary by Alice Chesterfield and Jordan Harvey<\/strong><\/p>\n<p>Despite much controversy, the functional-organic distinction attempts to distinguish symptoms, signs, and syndromes that can be explained by diagnosable biological changes (\u2018organic\u2019) from those that cannot (\u2018functional\u2019). It appears across medicine but has particular relevance in neuropsychiatric settings where it is often central to treatment decisions and service organisation.<\/p>\n<p>Past research has shown that clinicians disagree about the conceptual basis of the distinction and there are numerous medical problems where attributing causation to \u2018functional\u2019 or \u2018organic\u2019 factors is an ambiguous process.<\/p>\n<p>Consequently, we completed a qualitative study with psychiatrists, psychologists and neurologists working in relevant services to understand how they made sense of the distinction in their clinical work.<\/p>\n<p>Clinicians in the study understood \u2018organic\u2019 factors as having clear, physical causes which could be identified by unambiguous medical tests while \u2018functional\u2019 factors were often invisible and to be hypothesised through thinking and conversation. Both are caricatures of complex causal mechanisms in neuropsychiatry but seem to act as exemplars.<\/p>\n<p>In practice, clinicians reported that contextual factors, like cultural assumptions, service demands, patient needs and colleagues\u2019 views were key in how the distinction was deployed. Although the distinction was seen as imperfect and sometimes scientifically unsustainable, physicians reported using it strategically to explain medical problems, coordinate care, address stigma, and give patients access to a sense of identity related to their condition.<\/p>\n<p>Clinicians felt themselves constantly managing the tension between the conceptual coherence of the distinction and the practical demands of healthcare, and ambiguity was considered both an obstacle and a benefit in this.<\/p>\n<p>&nbsp;<\/p>\n<p>Listen to the author discuss the article below:<\/p>\n<audio class=\"wp-audio-shortcode\" id=\"audio-3869-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2024\/04\/Chesterfield-Alice-Meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services.mp3?_=1\" \/><a href=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2024\/04\/Chesterfield-Alice-Meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services.mp3\">https:\/\/blogs.bmj.com\/medical-humanities\/files\/2024\/04\/Chesterfield-Alice-Meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services.mp3<\/a><\/audio>\n<p>&nbsp;<\/p>\n<h3>Read the full article on the <a href=\"https:\/\/mh.bmj.com\/content\/50\/1\/170\"><strong><em>Medical Humanities <\/em>journal website<\/strong><\/a>.<\/h3>\n<p>&nbsp;<\/p>\n<p><em><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-3872 size-medium\" src=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2024\/04\/Chesterfield-Alice-Meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services-Chesterfield-Harvey-e1712307382759-262x300.jpg\" alt=\"Photo of Alice Chesterfield and Jordan Harvey\" width=\"262\" height=\"300\" srcset=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2024\/04\/Chesterfield-Alice-Meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services-Chesterfield-Harvey-e1712307382759-262x300.jpg 262w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2024\/04\/Chesterfield-Alice-Meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services-Chesterfield-Harvey-e1712307382759-640x734.jpg 640w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2024\/04\/Chesterfield-Alice-Meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services-Chesterfield-Harvey-e1712307382759.jpg 656w\" sizes=\"auto, (max-width: 262px) 100vw, 262px\" \/>Dr Alice Chesterfield and Dr Jordan Harvey are both Clinical Psychologists who completed this research as part of their training at University College London and work as practitioners for the UK\u2019s National Health Service.<\/em><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Article Summary by Alice Chesterfield and Jordan Harvey Despite much controversy, the functional-organic distinction attempts to distinguish symptoms, signs, and syndromes that can be explained by diagnosable biological changes (\u2018organic\u2019) from those that cannot (\u2018functional\u2019). It appears across medicine but has particular relevance in neuropsychiatric settings where it is often central to treatment decisions and [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/2024\/04\/18\/meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":345,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15028,15047],"tags":[15044],"class_list":["post-3869","post","type-post","status-publish","format-standard","hentry","category-journal-announcements","category-special-issues","tag-research"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Meaning and Role of Functional-Organic Distinction: A Study 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signs and syndromes in today&#039;s article summary.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-humanities\/?p=3869\" \/>\n<meta property=\"og:site_name\" content=\"Medical Humanities\" \/>\n<meta property=\"article:published_time\" content=\"2024-04-18T09:00:20+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2024\/04\/Chesterfield-Alice-Meaning-and-role-of-functional-organic-distinction-a-study-of-clinicians-in-psychiatry-and-neurology-services-Chesterfield-Harvey-e1712307382759-262x300.jpg\" \/>\n<meta name=\"author\" content=\"Chris Pak\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Chris Pak\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" 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