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Cognitive Behavioral Treatment (CBT) of Prolonged Grief and Functional Neurological Symptoms in Pakistan: A Case Report of Dual Diagnosis and Treatment

Home Cognitive Behavioral Treatment (CBT) of Prolonged Grief and Functional Neurological Symptoms in Pakistan: A Case Report of Dual Diagnosis and Treatment

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Abstract

The etiology of Functional Neurological Symptom Disorder (FNSD) can arise from various stressors, one of them being the loss of a loved one and grief. There is a lack of peer-reviewed clinical cases of patients presenting with the symptoms of both Prolonged Grief Disorder (PGD) and Functional Neurological Symptom Disorder (FNSD). The present case report describes a client from Pakistan with a dual diagnosis of FNSD and PGD. The client presented with the symptoms of FNSD and upon detailed evaluation, she also reported recently losing her mother to a sudden and violent accident two years ago In addition, the case also presented a picture of interpersonal issues, domestic responsibilities, and marital conflicts and their role in the development and maintenance of the symptoms. After the diagnosis and the assessment, her treatment plan followed cognitive behavioral therapy to deal with the FNSD symptoms and cognitive behavior therapy-based self-help techniques to deal with the symptoms of PGD. The client showed significant improvement in the symptoms following the treatment. This case highlights the sociocultural factors including stigma, gender roles, and marital dynamics underlying the development, maintenance, and treatment of dual diagnosis in Pakistan. It also provides a comprehensive treatment plan involving in-session treatment as well as training and using assisted self-help to foster empowerment and resilience in dealing with cases that are time-sensitive and require a more socioculturally nuanced approach to treatment.

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Funding

This case report did not receive any external funding.

Author information

Authors and Affiliations

  1. Visting Faculty, Department of Psychology, Government College University, Lahore, 54000, Pakistan

    Ayesha Akram

Corresponding author

Correspondence to Ayesha Akram.

Ethics declarations

Conflict of interest

The author declares no competing interests.

Consent to Participate

Informed consent was obtained from the client for participation in this case report. The client was informed of the nature of the case report, the voluntary nature of participation, and the right to withdraw consent at any time without consequence.

Consent to Publication

The author has obtained consent from the client to publish the details of this case report, ensuring confidentiality and privacy are maintained.

Ethical Approval

Ethical approval for this case report was obtained, and informed consent was secured from the client for the use of their clinical information. The patient’s confidentiality and anonymity were strictly maintained throughout the process.

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Akram, A. Cognitive Behavioral Treatment (CBT) of Prolonged Grief and Functional Neurological Symptoms in Pakistan: A Case Report of Dual Diagnosis and Treatment. J Contemp Psychother (2025). https://doi.org/10.1007/s10879-025-09675-9

  • Accepted
  • Published
  • DOI https://doi.org/10.1007/s10879-025-09675-9

Keywords

  • Functional Neurological Symptom Disorder
  • Prolonged Grief Disorder
  • Pathological grief
  • Cognitive behavior therapy

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