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 73 records · Page 4Linked to original sources
PubMed2000

[Reflex sympathetic dystrophy vs. a factitious disorder].

Three women aged 18, 30 and 21, were admitted with complaints of reflex sympathetic dystrophy. These patients were caught at inducing their symptoms. Factitious disorders may be more common and serious than expected. It is suggested to include this diagnosis routinely in the differential diagnosis when dealing with inexplicable complaints, symptoms or therapy resistance. If factitious disorders are diagnosed it is advised to confront the patients. This is important in order to limit further iatrogenic damage to the patient. It also allows the physician to inform other doctors. After confrontation quite a few patients will stop inducing their symptoms. Most of them become angry, deny self-induction and refuse psychiatric help. Sometimes patients will withdraw from treatment. Despite these negative reactions patient confrontation is mandatory.

Adolescent↗
PubMedDate not supplied

[Pseudoneurologic conversion and factitious disorders: differential diagnosis in 2 clinical cases].

The recognition and differentiation of conversion and factitious disorders could be difficult when they coexist with physical problems and their psychopathology is not evident. We present two illustrative cases of patients who share the existence of neurological disorders and present a similar psychiatric semiology, which is phenomenologically different related with their physical deficits. The psychopathological assessment was made by means of a standardized instrument for diagnosis (SCAN) and suitable paraclinical techniques for each case. The test MMPI (Minnesota Multiphasic Personality Inventory) was used in both cases, and an exploration with Thiopental was carried out in one of them. The pertinent differential diagnosis, the advantages of coordinated interdisciplinary interventions in order to elucidate these mental disorders, and the convenience of using appropriated psychometric instruments and exploratory methods are expounded in the present paper.

Conversion Disorder↗
PubMed1996

A bewitching case of factitious disorder in Zimbabwe.

A rural Zimbabwean man attributed the appearance of needles in his leg to witchcraft, but medical practitioners suspected that the needles were self-introduced. Psychiatric evaluation revealed no major mental illness. The patient met criteria for the Euro-American diagnosis of factitious disorder, persisting in his claim that he had been the victim of witchcraft. The patient's claim cannot be considered delusional because belief in witchcraft is culturally sanctioned within Shona culture. The case appears to be one of factitious disorder with both physical and psychological symptoms. Differential diagnoses must be broadened to consider culturally specific phenomena such as witchcraft.

Adult↗
PubMed1990

Factitious disorders in a general hospital setting: clinical features and a review of the literature.

Factitious disorder is an uncommon, but probably underdiagnosed, condition associated with considerable morbidity, mortality, and health care expenditure. This diagnosis was made in 10 (0.8%) of 1,288 patients consecutively referred to the psychiatric consultation-liaison service of a tertiary-care general hospital. Seven of 10 identified cases were female. Associated psychiatric disturbances included substance use, psychogenic pain disorder, malingering, dysthymic disorder, and borderline personality disorder. Only two cases accepted ongoing psychotherapy. One death due to factitious behavior occurred during the brief period of follow-up. Greater awareness of this condition among primary caregivers is necessary in order to improve case identification and to reduce associated morbidity.

Adult↗
PubMed1996

Factitious disorder by proxy: awareness among mental health practitioners.

Factitious disorder by proxy (FDP) is a form of abuse in which a caregiver surreptitiously simulates or induces illnesses in a person for whom he or she cares. Typically, a mother is the perpetrator and at least one of her children is victimized. FDP has a high morbidity and mortality rate, and a knowledgeable health team increases the primary physician's confidence in making this difficult diagnosis. The purpose of this study was to determine the levels of awareness of FDP among mental health practitioners and their sources of information. Anonymous questionnaires were sent to 687 primary care physicians and mental health practitioners. Psychiatrists (89%) and psychologists (69%) were more aware of the disorder than were social workers (42%). Years in practice were not associated with awareness of FDP. Psychiatrists were more likely than psychologists or social workers to have had exposure through an actual case or through their professional journals. These findings were statistically significant. Awareness of FDP varies significantly among mental health professionals and may reflect the availability of information during training and in journals. Since social workers and psychologists often have earlier and broader opportunities than psychiatrists to interface with families, enhancements in training and the professional literature in these disciplines are needed if FDP is to be consistently considered and identified.

Alabama↗
PubMed1998

Two siblings poisoned with diphenhydramine: a case of factitious disorder by proxy.

We report a case of factitious disorder by proxy (FDBP), formerly known as Munchausen syndrome by proxy, in which 2 siblings were poisoned with diphenhydramine. Although diphenhydramine is a readily available medication, no report of its use as the sole agent in an FDBP case was found in a literature search. Although sibling involvement in FDBP is well documented, this is the first case report of 2 siblings hospitalized simultaneously because of intentional poisoning with the same substance. Finally, the use of physostigmine to definitively diagnose anticholinergic poisoning in a case of FDBP has not previously been described.

Antidotes↗
PubMed1995

Tangled in the web: countertransference in the therapy of factitious disorders.

OBJECTIVE: Patients who simulate or actually self-induce illnesses to assume the "sick role" present a number of imposing psychotherapeutic challenges. The purpose of this article is to discuss the countertransferential reactions that are mobilized in therapy with these patients. METHODS: Literature searches of the MEDLINE and HEALTH databases were performed using the term "factitious disorder." The resulting citations were examined for descriptions of the potential and actual countertransference responses in therapy with such patients. The few citations with relevant material were supplemented with other clinical literature on countertransference as well as observations from cases in which the authors have served as therapists or consultants. RESULTS: Once the medical dissimulation has been exposed, the most conspicuous difficulty is in persuading the patient to agree to therapy. When therapy does take place, both the patient's overt behaviors, such as actual bodily damage, and his or her underlying emotional issues can mobilize particularly intense reactions in the therapist. CONCLUSIONS: Recognition and management of the countertransference reactions likely to emerge in therapy with factitious disorder patients are particularly important if the therapy is to be maximally effective.

Countertransference↗
PubMedDate not supplied

Factitious disorders and pathological self-harm in a hospital population: an interdisciplinary challenge.

Factitious disorder, Munchausen's Syndrome, and deliberate self-harm have recently been conceptualized as different facets of self-destructive behavior. A descriptive typological classification has been presented by Willenberg et al., but has not yet been tested with a clinical sample. The instrument distinguishes between direct self-harm (e.g., self-inflicted wounds), self-induced disease (e.g., factitious fever), and indirect self-harm delegated to medical staff (e.g., repeated operations occasioned by feigned symptoms). All patients referred to the psychosomatic-psychotherapeutic liaison-consultation service or to the outpatients' department within 14 months (n = 995) and all patients discharged from in-patient psychosomatic-psychotherapeutic treatment within 2 months (n = 62) were assessed. Expert instruction and supervision were provided for the diagnosticians. The assessment was continued for a subsequent year, without special supervision (n = 1,058). Self-destructive behaviors were diagnosed in 7.5% of the cases in the first sample, with certainty (59.5%) or on suspicion (40.5%). In the subsequent sample without supervision, the rate reduced to 3.6%. Referrals had come from almost all clinical departments, including the emergency unit (26%), surgery, internal intensive care, endocrinology (9.5% each), neurology, infectiology, nephrology (7.1% each), dermatology, gastro-enterology, cardiology (4.8% each) and surgical intensive care (2.4%). The occurrence of pathological self-destructive phenomena is underrated when using only the ICD-criteria. The rate is influenced by diagnostic attention.

Adolescent↗
PubMed2001

Factitious disorders of the upper limb in Saudi Arabia.

This prospective study investigated 28 patients with factitious disorders of the upper limb. Several cases did not fit any of the well-known factitious syndromes such as SHAFT or Münchhausen syndrome. Patients were divided into five groups, three of which comprised active mutilators who either induced wounds, introduced foreign bodies or induced arm swelling and oedema. Passive mutilators were considered in a separate group and were defined as those who complained of factitious pain or numbness of the limb, for which there was no secondary gain regarding employment or compensation: these patients underwent surgery and hence persuaded the surgeon to do the mutilation. The fifth group of patients exhibited hand posturing and were divided into two subgroups: patients with psychological hand posturing and those seeking secondary gain (malingerers). The clinical presentation, diagnosis and outcome are described for each group.

Adolescent↗
PubMed2005

Factitious disorder and malingering in adolescent girls: case series and literature review.

Six cases of factitious disease and malingering in pediatric patients referred to an infectious diseases practice in a tertiary care children's hospital are described, and implications for general clinical practice are reviewed. All patients were girls aged 9-15 years. Two patients were malingering with the secondary gain of avoiding attendance at school. The other 4 patients presented with factitious illness without clear link to secondary gain, but rather for a psychological purpose. Three of the subjects admitted to self-induced or feigned illness. The 2 patients diagnosed with malingering did very well with early parental support, psychotherapy, and attention paid to school difficulties. The outcomes of the others with underlying psychological conflicts were less resolved. Factitious disorders and malingering occur in the pediatric population. A high index of suspicion is needed for prompt diagnosis and care.

Adolescent↗
PubMed1996

Obstetric factitious disorder: is it more common than we think?

This case discusses the diagnosis of obstetric factitious disorder in a 27-year-old woman with bleeding per vagina. The case illustrates the need for a high index of suspicion in patients with unexplained physical symptoms during pregnancy, and highlights issues related to subsequent child care.

Adult↗
PubMedDate not supplied

[Factitious disorders and Munchausens's syndrome. The state of research].

.5-2% of patients of general medicine suffer from factitious disorders. These disorders require utmost skill in recognition, diagnosis and treatment; inadequate treatment may result in severe complications. Literature has grown tremendously during recent years, but many physicians are still not adequately aware of the specific problems. The current state of research concerning phenomenology, pathogenesis, psychopathology, psychodynamics and therapy is presented and discussed.

Factitious Disorders↗
PubMed1987

A case of factitious disorder presenting as plumbism.

The case of a young man who presented with lead poisoning is reported. This did not resolve with prolonged treatment and he had several unusual and unexplained bacteraemias. Probable sources of self-administered lead and bacteria were demonstrated and psychiatric assessment showed that the patient had a personality disorder which was consistent with a diagnosis of factitious disorder. Psychiatric management led to the termination of the self-inflicted illnesses and enabled the patient to cope with his personal and social problems.

Adult↗
PubMed1998

Pseudologia fantastica, factitious disorder and impostership: a deception syndrome.

Pseudologia fantastica and impostership are not currently included in diagnostic systems, although there is an overlap between these two syndromes and factitious disorder. A case which illustrates the overlap is described, and the diagnostic dilemma is discussed. A term 'deception syndrome' is proposed for those individuals who pathologically deceive for internal (i.e. psychological) as opposed to external reasons such as financial gain.

Adult↗
PubMed1994

Factitious disorders and the psychosomatic continuum in children.

A continuum may be described as spanning between the psychological reactions of children and families to a child's illness, the exaggeration or simulation of symptoms for psychological reasons, and the production of factitious symptoms in the child by the parent. However, there are critical clues that allow the alert clinician to recognize where his patient falls on the continuum. Because factitious disorders are uncommon and Munchausen syndrome by proxy is rare, awareness of psychiatric and clinical signs is important to prevent morbidity or mortality.

Child↗