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At least 307 records · Page 17Linked to original sources
PubMed1985

False patients/real patients: a spectrum of disease presentation.

This paper presents a synthesis of varying frameworks and value systems in which all patients are viewed by clinicians. A gradient of behaviors is arrayed which places disease simulation (Munchausen syndrome, malingering) at one end of a spectrum, with the other end anchored by 'real' disease. Between these two polarized opposites are placed the patients with 'psychological' origins to somatic presentations. These patients often called 'crocks' are somewhat different from those patients who present with disease simulation. Such patients are often referred to as 'crooks' in that they are absolutely false in their presentation and aware of such deception. The advantage of this particular schema is that it presents a gradient of behavior instead of isolated categorization. As such it is much more easily understood and used by clinicians and it presents the 'normal' and 'abnormal' within a single conceptual gradient instead of discreet categories.

Adult↗
PubMed1985

An empirical study of psychosis in borderline personality disorder.

To assess the nature and prevalence of psychotic symptoms in borderline personality disorder, the authors reviewed the cases of 33 patients meeting DSM-III criteria for borderline personality disorder, using both "narrow" and "broad" definitions of psychosis. Only eight patients displayed psychotic symptoms meeting the "narrow" DSM-III definition; in all of these cases, the symptoms appeared to be attributable to either severe drug abuse or major affective disorder, present simultaneously with borderline personality disorder. The remaining patients displayed only "broadly defined" psychotic symptoms or symptoms that appeared to be under voluntary control. These findings weigh against the assumption that borderline personality disorder lies "on the border" of classical psychotic disorders.

Adolescent↗
PubMed1986

The manipulative patient.

"Manipulative" is a popular but often misused description of behavior seen in some patients who come to psychiatric attention. The authors suggest a definition of "manipulation" which can impart helpful information about symptoms, diagnosis, and treatment. They survey the differential diagnosis of manipulative behavior and consider specific treatment strategies.

Antisocial Personality Disorder↗
PubMed1990

Confrontation naming deficit in dementia of depression.

Unlike patients with irreversible dementia, elderly depressed patients with cognitive impairment are thought to have relatively preserved recognition, memory, and language abilities. To test this hypothesis, the authors compared memory and naming performance in elderly hospitalized patients with major depression alone, reversible dementia of depression, or irreversible dementia. All patient groups performed worse than nondemented, nondepressed control subjects on memory tasks. Patients with dementia of depression performed worse than depressed patients with normal cognition on tests of free recall, delayed recall, and verbal delayed memory but not on tests of delayed visual memory. Patients with dementia of depression and patients with irreversible dementia were severely compromised in both speed and accuracy on the confrontation naming task.

Aged↗
PubMed1995

The Charles Bonnet syndrome: a brief review and case report.

A case of a woman with visual hallucinations in the absence of other organic or psychiatric findings--symptoms consistent with a diagnosis of Charles Bonnet syndrome--is reported. The women was HIV positive, although asymptomatic for conventional complications of HIV infection. After considering possible causes of the hallucinations, including prescription drug effects and conversion or factitious disorder, the authors suggest that the woman's symptoms may have been associated with undetectable effects of HIV on the brain.

AIDS Dementia Complex↗
PubMed1997

Munchausen's syndrome: a medico-legal dilemma.

In his or her life-long career, the physician will eventually encounter a patient with factitious disorder, or Munchausen's syndrome. We discuss two patients complaining of renal colic that were identified as having Munchausen's syndrome. We review the literature to identify certain aspects of the disease and to discuss the medical and legal implications for the treating physician and hospital.

Adult↗
PubMed2006

A case of Munchausen syndrome by proxy with subsequent stalking behavior.

A case of Munchausen syndrome by proxy (factitious disorder by proxy) wherein the patient presented with symptoms of severe borderline personality disorder and questionable psychotic symptoms is discussed. This patient was also adjudicated for harassing and stalking a child protective services worker assigned to her case. Issues pertaining to possible feigning of psychotic symptoms were addressed in her inpatient treatment. Despite doubts concerning the veracity of some of her psychotic symptoms, the patient responded well to clozapine, and she was subsequently able to stay out of the psychiatric hospital for longer periods and make a reasonably good adjustment to living in a group home. After refusing to continue with clozapine therapy because of weight gain concerns, her adjustment declined.

Adult↗
PubMed1982

Psychosomatic disorders in the elderly.

There is no agreement on the incidence or prevalence of psychosomatic disorders in the elderly. This is due in large part to the methodological difficulties of the epidemiological studies which have not employed the same diagnostic criteria and classification. Drawing on the literature and on clinical experience, a classification is offered, and using the diagnostic criteria explicit in this classification, probable trends are identified. Pseudodementia may well be the only stress-related disorder that is peculiar to the elderly.

Aged↗
PubMed1986

Psychiatric disorder in the general hospital.

There have been many reports of psychiatric disorder in medical populations, but few have used standard methods on representative patient groups. Even so, there is consistent evidence for considerable psychiatric morbidity in in-patient, out-patient and casualty department populations, much of which is unrecognised by hospital doctors. We require a better classification of psychiatric disorder in the general hospital, improved research measures, and more evidence about the nature and course of the many different types of problem so that we can provide precise advice for their management of routine clinical practice.

Alcoholism↗
PubMed1988

Feigned alcohol abuse. A unique case report.

A man presenting with factitious alcohol abuse and its alleged complications is described. It is argued that chronic factitious disorders are more logically viewed as part of that spectrum of conditions where there is abnormal illness behaviour, including somatoform disorders and other related conditions, than as separate nosological or diagnostic entities.

Adult↗
PubMed1996

Factitious Cushing syndrome.

There have been few reports of factitious Cushing syndrome. To characterize the clinical and laboratory features leading to this unusual diagnosis, we describe 6 patients (5 women, 1 man), ages 31-44, identified retrospectively among 860 patients evaluated for hypercortisolism at the National Institutes of Health Clinical Center. All six patients had multiple surgeries unrelated to Cushing syndrome and a history of depression or anxiety. Four patients had close contact with the medical profession, three a history of drug abuse, and three had undergone previous treatment for Cushing syndrome. The physical features of Cushing syndrome were variable and not helpful in the differential diagnosis with endogenous Cushing syndrome. Four patients had striking variability in urine-free cortisol (UFC) and 17-hydroxysteroid (17-OHCS) values from low to high. Adrenal computed tomography, performed in two patients, showed small adrenal glands (n = 1) or a left-sided mass (n = 1), and adrenal magnetic resonance imaging, performed in one patient, showed atrophic glands. Pituitary magnetic resonance imaging, carried out in four patients, was either normal (n = 1) or exhibited questionable signs of microadenoma (n = 3). Determination of synthetic glucocorticoids by high pressure liquid chromatography (HPLC) was positive in the four patients in whom it was performed. Factitious Cushing syndrome is a difficult diagnosis. To conserve time and resources, high pressure liquid chromatography analysis of urine steroids, the most definitive test for the factitious disorder, should be performed whenever there is clinical suspicion of glucocorticoid abuse.

Adrenal Glands↗
PubMed1988

Epileptic Munchausen's syndrome: a form of pseudoseizures distinct from hysteria and malingering.

A young woman with seizures and status epilepticus sought and obtained hospitalization in at least 25 hospitals in the province of Quebec between 1980 and 1987. She was thought to have uncontrolled epilepsy; her treatment led to intoxication with anticonvulsants and once to anesthesia for three consecutive periods of 7 days each. The nonepileptic nature of her attacks was proven and a diagnosis of Munchausen's syndrome made. She was transferred to a psychiatric center where she committed suicide. We found no documented cases of epileptic chronic factitious disorder in the literature.

Adult↗