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At least 739 records · Page 41Linked to original sources
PubMed2005

Self-inflicted skin diseases. A retrospective analysis of 57 patients with dermatitis artefacta seen in a dermatology department.

We analysed clinical symptoms, gender, age and social relations among 57 patients for whom a final diagnosis of dermatitis artefacta was established. The study is retrospective and the patients were seen in our department from 1982 to 2002. We observed that the diagnosis was 2.8 times more common in females than males. Symptoms were most common in the age group 18-60 years, median age 39 years. The skin lesions were 'multiple' among 88% of the patients. When self-infliction was suggested as the cause, two-thirds of patients initially denied it and only one patient agreed to meet with a psychiatrist. Only one-quarter had a job, the rest were unemployed or on sick leave. Many patients (61%) received medical treatment with anxiolytica. Ten patients (18%) had a psychiatric diagnosis. Among our 57 patients, 11 were deceased at the time of our study, but none because of suicide. Four had died before the age of 70, of whom two suffered from alcoholism and two had diabetes mellitus. Therapy should include an optimal nursing relationship with the patient so that social problems can be discussed. Psychological or psychiatric intervention appeared unhelpful because of patient denial.

Adolescent↗
PubMed2000

Can the impact of hearing impairments be modelled?

The effects of two simulated hearing impairments (presbyacusis) on speech perception were investigated in two groups of normally hearing subjects (30 and 48 subjects, respectively). Eight patients with presbyacusis with similar hearing impairment to those in the latter simulation served as the clinical material. Word recognition scores were measured in quiet and in cocktail party noise (S/N + 18 dB and + 12 dB). The recognition scores deteriorated in the less favourable listening conditions. Somewhat surprisingly, the hearing impaired subjects showed better word recognition scores in quiet and especially in moderate noise. Subjective complaints on speech perception difficulties in noise on a visual analogue scale behaved quite logically; the hearing impaired subjects' subjective experiences were no milder than those of the normally hearing during the simulation. The better results in word recognition shown by the hearing aid candidates may be explained by habituation to the hearing impairment.

Adolescent↗
PubMed1985

Early Alzheimer's disease or dementia from another cause?

It is unusual for Alzheimer's disease to present with focal neurologic abnormalities. Most patients have generalized and progressive dementia without signs of systemic disease. Perhaps the most characteristic feature is the absence of significant medical or focal neurologic abnormalities in the presence of severe dementia.

Adult↗
PubMed1994

Fictitious twins, factitious illness.

Five patients who sought hospitalization with factitious illnesses also feigned or fantasied loss of a twin. This unusual presentation suggests the possibility that fantasied twin loss may have dynamic implications. The patients are described and discussed in relation to factitious illness, factitious bereavement, and twin fantasies. Their fictional twin bereavement appeared aimed, in part, at stabilizing a fragile sense of self and gaining sympathetic support from others. This presentation should alert one to investigate the story, inviting the person's participation in gaining corroborating information, and--should the story prove false--to support the individual in less victimizing adaptations.

Adult↗
PubMed1984

Problems and conceptual issues in neuropsychological research in aging and dementia.

Neuropsychological investigation of old age and dementia faces all the problems associated with more general gerontological study. In addition, some specific difficulties in attempting to infer cerebral status from behavioral observation arise. These include uncertainty about the nature and course of normal aging, about the influence of disease and affective disturbance on performance, and about the significance of diverse interactive effects. Further, the concept of dementia requires clarification. These issues are addressed and their clinical implications discussed.

Aged↗
PubMed1987

Neuropsychological evidence of a factitious memory complaint.

The authors describe a patient who complained of a severe memory loss. Information gathered from the history, interview, and testing suggested malingering. The patient was then assessed by a strategy called Symptom Validity Testing. Her score was statistically worse than chance, which provided compelling evidence that she was faking bad.

Amnesia↗
PubMed1990

Prospects for faking believable memory deficits on neuropsychological tests and the use of incentives in simulation research.

The vulnerability of several neuropsychological memory tests--the Wechsler Memory Scale--Revised, Complex Figure Test, Auditory Verbal Learning Test, and Rey Memory Test--to faked deficits was evaluated. Subjects were randomly assigned to one of three conditions: Control (n = 28), Malingering with a financial incentive (n = 30), and Malingering without a financial incentive (n = 28). Overall, the performance of the Malingering Groups was not significantly different from one another, but both groups were significantly poorer than Controls. Discriminant functions with a reduced set of predictors correctly classified about 75% of cases in both the Control and the combined Malingering Groups on cross-validation. The results suggest that neuropsychological memory tests are vulnerable to faked deficits, and that recognition tasks are disproportionately affected. The use of incentives in simulation research is also discussed.

Adult↗
PubMed2004

Medically unexplained symptoms and neuropsychological assessment.

Several illnesses expressed somatically that do not have clearly demonstrated pathophysiological origin and that are associated with neuropsychological complaints are reviewed. Among them are nonepileptic seizures, fibromyalgia, chronic fatigue syndrome, Persian Gulf War unexplained illnesses, toxic mold and sick building syndrome, and silicone breast implant disease. Some of these illnesses may be associated with objective cognitive abnormalities, but it is not likely that these abnormalities are caused by traditionally defined neurological disease. Instead, the cognitive abnormalities may be caused by a complex interaction between biological and psychological factors. Nonepileptic seizures serve as an excellent model of medically unexplained symptoms. Although nonepileptic seizures clearly are associated with objective cognitive abnormalities, they are not of neurological origin. There is evidence that severe stressors and PTSD are associated with immune system problems, neurochemical changes, and various diseases; these data blur the distinctions between psychological and organic etiologies. Diagnostic problems are intensified by the fact that many patients are poor historians. Patients are prone to omit history of severe stressors and psychiatric problems, and the inability to talk about stressors increases the likelihood of suffering from physiological forms of stress.

Behavioral Symptoms↗
PubMed1995

Factitious hyperthyroidism causing acute myocardial infarction.

Myocardial ischemia is a rare but severe and possibly life threatening manifestation of hyperthyroidism, but does not usually result in persistent ischemia. We report on a 71-year-old woman who had undergone total thyroidectomy with subsequent irradiation because of follicular carcinoma 3 years ago. Since then, she had been maintained on oral levothyroxine replacement therapy at a dose of 0.15 mg alternating with 0.2 mg daily. When latent hypothyroidism became evident despite replacement therapy, the dose of levothyroxine was increased to 0.3 mg a day. Three weeks later, the patient suffered from an acute posterior myocardial infarction, although she had no previous history of coronary artery disease. Subsequent coronary arteriograms revealed no evidence of disease of the major vessels. Myocardial scintigraphy 3 weeks after infarction still revealed a persistent perfusion defect. Since it is known that thyroid hormones increase oxygen demand, the rapid elevation of oxygen utilization caused by thyrotoxicosis factitia is likely to be responsible for this patient's myocardial infarction. The case illustrates that a sudden increase in levothyroxine replacement dose should be avoided.

Acute Disease↗
PubMed1991

Arthritis artefacta: factitious disease in rheumatology.

Self-induced disease can be difficult to diagnose and costly of time and money to investigate. The key is to think of the possibility. Five patients in whom the evidence for factitious rheumatological illness was strong are discussed and their histories, physical signs and family backgrounds are explored in relationship to factitious disease presenting in other fields. Young immature individuals seem most at risk and the discrepancy between physical signs and understandable pathological mechanisms may suggest the diagnosis. The outlook seems frequently poor.

Adolescent↗