Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Factitious Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed1993

Bacteremia due to Enterococcus avium.

Enterococcus avium, formerly "group Q streptococcus," has rarely been reported as a pathogen in humans. To determine the clinical significance of this organism, we reviewed the records of all patients whose blood cultures were positive for E. avium who were seen at our institution from 1986 through 1991 and identified nine cases of bacteremia due to E. avium. All isolates were believed to be clinically significant. Five of nine cases developed in patients with significant gastrointestinal illnesses. The remaining clinical scenarios included intravenous catheter sepsis and factitious disorders. E. avium bacteremias were polymicrobial in seven cases; in six cases, the coisolates were gastrointestinal organisms. These observations suggest that E. avium bacteremia most often originated from a gastrointestinal tract source. We conclude that, though rare, E. avium can be pathogenic in humans and that E. avium bacteremia is associated with gastrointestinal abnormalities.

Adult↗
PubMed1993

Automatic and effortful memory processes in depressed persons.

Clinical lore has held that depression results in memory dysfunction, particularly in older adults. Some believe that memory loss due to depression is indistinguishable from an organic dementia and label such dysfunction pseudodementia. Previous literature has inconclusively supported the relation between depression and memory deficits. This research assessed three groups of subjects: (a) 30 depressed patients, (b) 20 psychiatric controls, and (c) 30 normal controls. Dependent memory tasks were designed to vary along the automatic and effortful memory encoding continuum defined by Hasher and Zacks (1979). Two tasks were designed to be effortful (free recall and paired associates) and two tasks were designed to be automatic (memory for frequency and location). Contrary to predictions, depression was not related to memory deficits. However, post-hoc analyses indicated that psychiatric hospitalization and psychotropic medication had a greater negative impact on memory than did depression. As predicted, age resulted in effortful encoding deficits whereas age resulted in minimal deficits on the automatic tasks. There was no evidence of an interaction between depression and age that would be consistent with the descriptive label of pseudodementia.

Adolescent↗
PubMed1991

More Munchausen with chronic pain.

Munchausen's syndrome is a popular name for a factitious disorder with physical symptoms. We have identified four Munchausen patients within a sample of 2,860 chronic pain patients for a frequency of 0.14%. These patients are described and an attempt is made to develop a profile of the Munchausen patient presenting with chronic pain.

Adult↗
PubMed1999

Munchausen by proxy syndrome: the forensic challenge of recognition, diagnosis, and reporting.

Munchausen by Proxy Syndrome (MBPS) is a rare form of abuse in which a caregiver fabricates or produces symptoms of an illness in a child, elder, or disabled person. The deception is usually repeated on numerous occasions, resulting in many hospitalizations, considerable morbidity, and sometimes death. MBPS is a factitious disorder in which caregivers injure their victims in order to gain sympathy or attention for themselves. It was named after Baron Karl von Munchausen, the 18th century cavalry officer who returned home from war and told embellished tales of his adventures. MBPS is a very horrifying circumstance of abuse. Unwillingness or the inability to recognize this abuse deprives the victim of the opportunity to be shielded from future harm. There is a need for strategic protocols and a multidisciplinary approach to this baffling problem. Discussing the clinical profile of the perpetrator, the victim, and the family may help nurses distinguish medical fact from fiction.

Adult↗
PubMed1997

Case study: Ganser syndrome in children and adolescents.

Six cases of the Ganser syndrome have been previously described in the literature and are reviewed here. They are imperfect representations of the originally described syndrome. This article describes a case of the Ganser syndrome in a 12-year-old boy who, after a mild head injury, presented with three of four of the core symptoms. The nature of the Ganser syndrome remains unclear, but this case study highlights dissociation and abnormal illness behavior as being important in the production of the symptoms. Classically the course is short-lived, although this report raises the possibilities of a much more chronic course.

Adolescent↗
PubMed2003

Malingering by proxy: a form of pediatric condition falsification.

The deliberate production or feigning of signs or symptoms in a child by a caretaker is well recognized as factitious disorder by proxy, a psychiatric condition commonly reported in the pediatric literature. However, it is not as well recognized that the false illness portrayal may also be the result of a parent instructing the child to malinger. A case report of a 13-year-old patient who feigned an immobile upper extremity for the purpose of obtaining a legal settlement is presented. Physicians are encouraged to make protecting the child from parental or iatrogenic harm a priority. Recommendations for careful confrontation and expedient resolution are made.

Accidents↗
PubMed1988

Ganser symptoms, dissociation, and dysprosody.

Approximate answers (vorbeireden) are considered pathognomonic of the Ganser syndrome. Controversy has always surrounded the nosological status of this syndrome. Its recent inclusion in the DSM-III-R as a dissociative disorder is supported by this case report. The association of approximate answers, psychogenic amnesia, and dysprosody is reported here for the first time.

Adult↗
PubMed1997

Brodifacoum rodenticide ingestion in a patient with shigellosis.

Factitious disorders are characterized by the intentional feigning or induction of signs and/or symptoms in order to assume the sick role. The spectrum of diseases and symptoms simulated is extensive. Although some patients may seek only the gratifications of the sick role, typically patients seek health care for their afflictions. We report the case of a woman with a history of numerous unexplainable illnesses and laboratory findings who had shigellosis. On routine evaluation, a severe prothrombin coagulopathy was discovered and later determined to be caused by brodifacoum, a "superwarfarin" drug found in potent rodenticides. The patient was successfully treated with daily vitamin K. She continued to deny intentional or accidental ingestion but did consent to psychiatric treatment.

4-Hydroxycoumarins↗
PubMed2004

Munchausen's syndrome presenting as severe panniculitis.

Factitious disorders may trouble any physician during his/her career. A considerable number of cases of Munchausen's syndrome (self-induced disorder) are misdiagnosed in clinical practice. A 36-year-old woman was admitted to our hospital because of fever and abdominal pain. Physical examination showed signs of inflammation of the abdominal wall, and histological examination revealed severe panniculitis. We investigated various aetiologic factors that could probably be related to fat necrosis, but we found no explanation of the phenomenon until we verified the diagnosis of Munchausen's syndrome. 2 years later, the patient underwent surgery for removal of needles, which she herself had deliberately located under her skin. High index of suspicion and physician's persistence are necessary to make the correct diagnosis in the various protean manifestations of Munchausen's syndrome.

Acute Disease↗
PubMed1992

Pseudodementia and delirium in depression: a contribution to psychosomatic medicine.

Presenting cases of depressional pseudodementia and delirium, we wish to point out the following points in this report. The patient in depression displays a state of pseudodementia when he is regarded as having senile dementia by the people around him. The depressed patient falls into delirium when he is embarrassed by an unexpected situation. In other words, the patient shows pseudodementia when he is continuously out of the world of daily meaning; he would fall into a disturbance of consciousness when he is suddenly put out of the world of meanings. This principle is applicable not only to depression but also to all mental diseases. In mental diseases, the symptoms themselves have some meaning for the patient. However, when the patient is put out of the world of ordinary meaning, mental disease presents the aspect of a somatic disease such as dementia or disturbance of consciousness.

Aged↗
PubMed2004

The borderline syndrome in psychosomatic dermatology. Overview and case report.

The borderline syndrome is one of the most severe disturbances of psychosomatic dermatology. Patients with borderline syndrome are situated 'on the border' of psychosis, neurosis and personality disorders. The skin as a borderline organ carries a symbolic role. The clinical picture includes artefactual skin diseases due to self-mutilation by conscious or unconscious cutting, and rubbing, scratching or para-artefactual manipulations of pre-existing dermatoses. Leading symptoms of the borderline syndrome are poor impulse control, emotional instability and poor ego strength with low frustration tolerance and unstable personal relationships. We present the case of a 38-year-old female patient with borderline syndrome suffering from para-artefactual skin diseases of the face and a massive hyperhidrosis of the hands and feet. Within 9 months she was treated in four acute psychiatric hospitals and by 12 psychiatrists and psychotherapists. Early and accurate diagnosis and high-quality, sophisticated long-term therapy are necessary.

Adult↗
PubMed1988

The family systems of Munchausen syndrome by proxy.

Munchausen Syndrome by Proxy describes a parent who fabricates the appearance of physical illness in a child. Previous descriptions of the syndrome have focused exclusively upon medical or psychiatric assessments of the involved child and perpetrating parent. The family evaluations of two cases presented here suggest that Munchausen Syndrome by Proxy may be a systemic syndrome generated when a mother already possessing a somatoform or factitious disorder joins an enmeshed, authoritarian family system possessing a systemic history of exploitation of children. We suggest that measures instituted to protect the abused child must take into account the systemic function of the Munchausen by Proxy behavior in maintaining family stability, lest such measures be rendered ineffective by family members. When there is ongoing victimization of perpetrating parents in a similar pattern of dominance/submission within their own family of origin, disruption of these intergenerational patterns of exploitation may be a necessary component of treatment.

Adult↗
PubMed1981

Treatment of depression in the elderly. General clinical considerations.

Epidemiological investigations indicate that there is a high incidence of affective disorders in the elderly. Women predominate over men which may be due to diagnostic problems. It is a general assumption that socio- and psychogenic factors, somatic illness and treatment with drugs have etiological importance for affective disorders in the elderly. This assumption needs further investigation, however. Post mortem investigations have shown that there are biochemical changes in the brain in the elderly and in dementia disorders, indicating that there is a reduced activity in the serotoninergic and cholinergic systems. These biochemical changes may increase vulnerability to affective disorders in the elderly and in demented patients. When discussing the cause of the high incidence of affective disorders among the elderly a chain of factors must be considered. Psychogenic and sociogenic factors may precipitate the disease but biochemical disturbances related to the ageing process may make the individual vulnerable to affective disorders. Theoretically zimelidine seems to be the drug of choice when treating affective disorders in the elderly.

Adult↗
PubMed1983

Clinical features and motives among 42 artifactual illness patients.

This paper describes the salient clinical features and histories of 42 patients whose artifactual condition gained them admittance to hospital. Most were female, single, separated or divorced, emotionally deprived in childhood and/or adulthood, and 'psychopathic'. Also common were poor work records, court convictions, drug and/or alcoholic histories and aggressive traits and/or acts. However, 50 per cent were in caring professions and 28 per cent socially conformist. Distinct subgroups were wanderers, non-wanderers, single-system and multiple-system patients, haemorrhagic and psychiatric patients. Seventy-four per cent seemed to be experiencing severe unacknowledged sexual and/or marital problems, 32 per cent sought more general attention, 10 per cent were compensating for loss of parents or spouse, and 12 per cent were escaping things or trying to obtain things retrospectively. Haemorrhagic and psychiatric subgroups of artifactual illness had not previously been described. Non-wanderers were significantly more cooperative in follow-up than wanderers. The psychopathology of this disturbance is discussed.

Adolescent↗
PubMed1999

Unnatural sudden infant death.

AIM: To identify features to help paediatricians differentiate between natural and unnatural infant deaths. METHOD: Clinical features of 81 children judged by criminal and family courts to have been killed by their parents were studied. Health and social service records, court documents, and records from meetings with parents, relatives, and social workers were studied. RESULTS: Initially, 42 children had been certified as dying from sudden infant death syndrome (SIDS), and 29 were given another cause of natural death. In 24 families, more than one child died; 58 died before the age of 6 months and most died in the afternoon or evening. Seventy per cent had experienced unexplained illnesses; over half were admitted to hospital within the previous month, and 15 had been discharged within 24 hours of death. The mother, father, or both were responsible for death in 43, five, and two families, respectively. Most homes were disadvantaged--no regular income, receiving income support--and mothers smoked. Half the perpetrators had a history of somatising or factitious disorder. Death was usually by smothering and 43% of children had bruises, petechiae, or blood on the face. CONCLUSIONS: Although certain features are indicative of unnatural infant death, some are also associated with SIDS. Despite the recent reduction in numbers of infants dying suddenly, inadequacies in the assessment of their deaths exist. Until a thorough postmortem examination is combined with evaluation of the history and circumstances of death by an experienced paediatrician, most cases of covert fatal abuse will go undetected. The term SIDS requires revision or abandonment.

Asphyxia↗