Functional neurological disorder in Australia

Functional neurological disorder (FND) is a condition that results from improper functioning of the central nervous system. The nervous system is not damaged, but signals between the brain and different parts of the body are disrupted, causing changes in movement ability, senses, speech and thinking (Neurological Council of WA 2023). Symptoms vary between people but can include:

• dissociative attacks (altered or loss of consciousness) that can look like seizures
• paralysis or limb weakness
• tremors
• problems with movement, balance or gait
• bowel and bladder problems
• severe fatigue
• problems with vision
• dizziness
• cognitive issues
• speech and swallowing difficulties
• impaired senses.

The causes of FND are unclear, but it can be brought on by a combination of biological, psychological and social factors such as genetics, physical injury, emotional or personality illnesses, early trauma, anxiety or stress and psychosocial adversity. Diagnosis is often made by a neurologist who looks for clinical signs such as tremors, limb weakness or a collection of the other symptoms identified above. There is no cure for FND, but the condition can be successfully managed with a multidisciplinary medical approach (FND Australia Support Services 2019).

This report presents both crude and age-standardised rates, where available. 

Crude rates are based on unadjusted data and indicate whether there is a difference between populations without accounting for differences in the age structures of the populations. 

Age-standardised rates are based on data that are adjusted to account for differences in the age structures of the populations.

Therefore, a difference between 2 populations in crude rates indicates that the rate differs between them. The differences may be due to any number of factors, including different age structures of the populations. In contrast, a difference between 2 populations in age-standardised rates indicates that the rate differs between them but that this difference is not due to different age-structures.

For example, a difference in the prevalence rate between males and females indicates that prevalence differs between them, and this difference in prevalence could be due to any number of risk factors, including age. A difference in the age-standardised prevalence rate between males and females indicates that prevalence differs between them and, furthermore, that this difference in prevalence is not due to age.

For more details about rate calculations see the Technical notes in the Neurological conditions in Australia report.

For interactive visualisations on hospitalisations and emergency department presentations for FND, see Figure 2 and Figure 3, respectively, in the Neurological conditions in Australia report. Change the toggles in the visualisations from “all neurological conditions” to “functional neurological disorder”.

For downloadable data tables, see Data section of this article.

Finkelstein et al. (2024) conducted a systematic analysis of prevalence estimates for FND and included an assessment of bias for each study in their analysis. They found that prevalence estimates varied greatly from study to study. The study they selected (Villagrán et al. 2021) had the lowest risk of bias and was quite recent. 

There are 2 main limitations of the source used for the prevalence estimate:

• the data are not from Australia but from Norway, and it is unclear whether the estimate from Norway generalises to Australia
• the estimate from the original source that Finkelstein et al. (2024) relied on was for the prevalence of functional seizures, which was converted to a prevalence for FND under the assumption that 30% of people with FND have functional seizures, which may or may not be true.

The prevalence estimates for females and males in this article are based on the reported prevalence of functional seizures for females and males in Villagrán et al. (2021), under the assumption that 30% of males and 30% of females with FND have functional seizures.

Given the lack of reliable sources of prevalence, and the fact that the prevalence of FND in Australia is unknown (Pepper et al., 2022), the estimate from Finkelstein et al. (2024) is the best current estimate.

Importantly, Finkelstein et al. (2024) noted that the estimate of 79 per 100,000 population is likely an underestimate, representing a minimum estimate of prevalence.

In December 2018, a national coding rule was published for the ICD-10-AM Tenth Edition (effective 1 January 2019) regarding classification of Functional Neurological Disorders (FND) in the code range F44.0 - F44.9. This likely resulted in more episodes of care for FND being captured and thus the increase in the number and rate of FND hospitalisations seen from 2018-19 onwards. In 2022 the codes for FND had been added to the Alphabetic Index of the ICD-10-AM for Twelfth Edition making the coding rule obsolete, and thus it was retired. These changes may indicate underreporting of FND hospitalisations prior to 2018-19 and should be taken into consideration when comparing hospitalisation trends over time.

Information on procedures in the National Hospital Morbidity Database (NHMD) is reported using the Australian Classification of Health Interventions (ACHI) which classifies surgical operations, procedures and other types of interventions performed for the purpose of investigating and/or remedying health state. 

In 2023–24, there were 13,800 procedures for hospitalisations with a principal diagnosis of FND. This equates to around 2.3 procedures per hospitalisation. Almost three quarters (74%) of these were generalised allied health interventions, 8.5% were psychological or psychosocial therapies, 4.4% were assessment of personal care and other activities of independence and 3.5% were other assessment, consultation, interview examination or evaluation.

For more information on surgeries and intervention types, see Surgery and other interventions.

Lagrand et al. (2023) estimated the total health-system costs of FND to be almost $3,300 (almost $2,400 USD) per patient per year. These costs were for ED presentations, hospital admission days, outpatient clinic visits, mental health reviews, pathology requests, imaging tests, EEG (electroencephalography) and medication use. A major limitation of this study is that the results are based on 25 patients from a single health care network in Queensland.

Seneviratne et al. (2019) estimated the health-system costs of FND to be almost $26,500 per patient until a diagnosis was established. Note that this is the cost estimate until a diagnosis was established, meaning that some patients would have incurred these costs over a period of a few years. These costs were for ED presentations, hospital ward admissions, admissions to intensive care units, outpatient neurological clinic visits and (various) investigations. A major limitation of this study is that the results are based on 39 patients from a single health care network at Monash.

There is therefore a current lack of reliable estimates for the health-system costs associated with FND in Australia.

The Neurological conditions in Australia 2025 project was undertaken by members of the Chronic Conditions Unit of the Australian Institute of Health and Welfare (AIHW).

The AIHW acknowledges the ongoing contributions and consultation provided by the Department of Health, Disability and Ageing and the Neurological Conditions Expert Advisory Group. A special thanks is extended to Dr Adith Mohan for his expert advice on functional neurological disorder. For further information on contributions to the project, see Notes in the Neurological conditions in Australia report.

ABS (Australian Bureau of Statistics) (2025) Population Australia: Population at 30 June, by sex and single year of age, Aust., from 1971 onwards [data set], National, state and territory population, September 2024, ABS website, accessed 6 June 2025.

AIHW (Australian Institute of Health and Welfare) (2025) Health system spending on disease and injury in Australia 2023–24 AIHW website, accessed 29 October 2025.

Finkelstein SA, Diamond C, Carson A and Stone J (2024) ‘Incidence and prevalence of functional neurological disorder: a systematic review’, Journal of Neurology, Neurosurgery & Psychiatry, 96:383–395, doi:10.1136/jnnp-2024-334767.

FND Australia Support Services (2019) Discover options for FND treatment in Australia, FND Australia Support Services website, accessed 23 May 2025.

Lagrand TJ, Jones M, Bernard A, Lehn AC. (2023) ‘Health Care Utilization in Functional Neurologic Disorders: Impact of Explaining the Diagnosis of Functional Seizures on Health Care Costs’ Neurology Clinical Practice, 13(1):e200111. doi: 10.1212/CPJ.0000000000200111.

National Disability Insurance Scheme (NDIS) (2025) Participants by diagnosis: Participants count by diagnosis data [data set], Participant datasets, NDIS website, accessed 28 March 2025.

Neurological Council of WA (2023) Understanding Functional Neurological Disorder, Neurological Council of WA website, accessed 23 May 2025.

Pepper E, Mohan A, Butcher K, Parsons M and Curtis J (2022) ‘Functional neurological disorders: an Australian interdisciplinary perspective’, The Medical Journal of Australia, 216(10):501–503, doi:10.5694/mja2.51543.

Seneviratne U, Low ZM, Low ZX, Hehir A, Paramaswaran S, Foong M, Ma H, Phan TG. (2019) ‘Medical health care utilization cost of patients presenting with psychogenic nonepileptic seizures’ Epilepsia, 60(2):349-357. doi: 10.1111/epi.14625.

Villagrán A, Eldøen G, Duncan R, Aaberg KM, Hofoss D, & Lossius MI (2021) ‘Incidence and prevalence of psychogenic nonepileptic seizures in a Norwegian county: a 10‐year population‐based study’, Epilepsia, 62(7):1528-1535, doi:10.1111/epi.16949.