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Results for “Factitious Disorders”

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PubMed1988

[A case of factitious hypoglycemia with unusual presentation].

In this paper the Authors describe a case of factitious hypoglycemia in a 30-year-old nurse who came to the practitioner saying she was drug-addict. A careful history and the clinical examinations showed that the symptoms were due to hypoglycemic episodes. The finding of high plasma insulin levels together with low plasma C-peptide concentrations enabled us to exclude organic causes of hypoglycemia, suggesting the diagnosis of factitious hypoglycemia. After the patient was told we suspected a case of factitious hypoglycemia, the symptoms disappeared.

Adult↗
PubMed1988

[Dissimulated dermatozoon delusion with severe skin artifacts].

A 37-year-old civil servant, who had been treated for 9 years for sycosis simplex, covered up the presence of his dermatozoon delusion, which had probably only developed in the course of time since the original diagnosis had been made. In a single examination performed when he was referred to our clinic, he admitted for the first time that he had been using sharp objects to dig out ingrown beard hair and mites. This practice had caused numerous sclerotic scars and ulcers on the facial skin. In our dermatological practice, this was an unusual finding in a patient with a dermatozoon delusion.

Adult↗
PubMed1988

Malingering vs. the factitious personality in chiropractic practice.

This article details how to identify and treat the malingering patient, which we feel is seen more often than was originally thought in chiropractic practice. A historical perspective of a malingering vs. a factitious personality is examined. The factitious patient is reviewed in detail with special attention to the classic case of Munchausen syndrome. An extensive treatment plan is discussed, including short- and long-term care. The common characteristics, objective tests and studies are reviewed. We theorize that due to our increasing involvement in Workers' Compensation and personal injury cases our attention should be focused more closely on the possibility of these types of patients entering our office.

Chiropractic↗
PubMed1988

[A test of symptom validity in assessing functional symptoms].

Symptom Validity Testing was developed to evaluate complaints of sensory deficits. The assessment is based on the inability of patients to perceive a sensory signal. Subjects must guess the signal using the model of coin flipping (head or tail). The signals are presented randomized in an equal number of alternatives. A 50-percent hit-rate for enough trials is expected in a true sensory deficit. Deceptive patients are expected to perform a hit-rate below the probabilities of chance.

Adult↗
PubMed1988

[The confusion relating to the concept of dementia and Alzheimer's disease].

Much confusion exists about the definition of the term dementia and about diagnostic criteria of dementing diseases. This confusion not only forms an impediment in the progress of scientific research, but is also potentially harmful for patient care. Recently, considerable improvements are made by consensus conferences in designing operational diagnostic criteria. However, application of these in daily practice is still not optimal. In this publication, differences in meaning of the concept of dementia and Alzheimer's Disease are discussed. A proposal is made how to overcome misunderstandings in daily practice.

Aged↗
PubMed1988

Factitious proteinuria: diagnosis and protein identification by use of isoelectric focusing.

Factitious proteinuria is an unusual finding. We present a case in which clinical suspicion was aroused by the disparity between the clinical history and findings and the 24-h excretion of protein in urine. Electrophoresis of the patient's serum and urine confirmed the presence of an unusual protein. By isoelectric focusing we identified it as egg-white, a finding confirmed by immunofixation with antiserum to egg-albumen. In the past, confirmation of the identity of such a protein has required specific antiserum for immunofixation or immunodiffusion. Such antiserum may not always be available. However, isoelectric focusing gives sufficient resolution for positive identification of exogenous proteins, even in the presence of true proteinuria.

Factitious Disorders↗
PubMed1986

Factitious diarrhoea.

Gastroenterologists often have to deal with patients with chronic diarrhoea. The vast majority will suffer from functional bowel syndrome. A few will present with a clear-cut organic disease. If chronic diarrhoea remains unexplained after extensive testing, if daily stool volume is high (greater than 500 g/24 h) and if the patient is female, factitious diarrhoea should be considered. Melanosis coli on sigmoidoscopy, cathartic colon on barium enema examination, a positive room search and chemical detection of the presence of specific laxatives in urine or stool may lead to the correct diagnosis. Treatment and management of such patients is difficult. Denial is the usual response to confrontation. Counselling and guidance by psychiatrists or psychologists is often not accepted by the patient. In many cases the role of the physician may be limited to preventing further potentially dangerous diagnostic and therapeutic interventions.

Adult↗
PubMed1987

The efficacy of empathy in diagnosis and treatment.

An integrated, "holistic" approach to the sick patient is an ideal that remains elusive under the best of circumstances but especially if the importance of affective empathic interactions is not emphasized. Although models of psychosomatic and/or psychobiological approaches abound, and in spite of additional courses in medical school pertinent to psychological issues, the cognitive may prevail while the affective is left to languish. The problem may well be that the cognitive elements of humanism, which make for an educated practitioner, are easier to address and therefore attract the greater attention, while the affective learning, which makes for a humane and compassionate practitioner, is so much more difficult to encompass in a curriculum. The practicing physician, however, is likely to find that without greater nurturance of the capacity for empathy, psychosocial or psychosomatic conceptualizations are likely to have little impact on clinical care of patients.

Empathy↗