Factitious disorder

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Background

  • The falsification of medical or psychological signs and symptoms in oneself or others that are associated with the identified deception, absent of obvious external rewards
  • Includes:[1]
    • Munchausen syndrome
    • Psychogenic seizures
    • 20% of patients in epilepsy clinics
    • 3.5% of kidney stone patients

Clinical Features

Factitious Disorder Imposed on Self

  • A. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception.[2]
  • B. The individual presents himself or herself to others as ill, impaired, or injured.
  • C. The deceptive behavior is evident even in the absence of obvious external rewards.
  • D. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.

Factitious Disorder Imposed on Another

  • A. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, on another, associated with identified deception.
  • B. The individual presents another individual (victim) to others as ill, impaired, or injured.
  • C. The deceptive behavior is evident even in the absence of obvious external rewards.
  • D. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.

Differential Diagnosis

Evaluation

Difficult to diagnose, as often a diagnosis of exclusion. Refer to the patient's medical record for indication of repeated visits, recurrent testing, or multiple identities.

Management

Close outpatient psychotherapy focused on establishing and maintaining a relationship with the patient.

Disposition

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See Also

External Links

References

  1. Heer JS. (2014). Factitious Disorders and Malingering. In J. Marx (Ed.), Rosen's Emergency Medicine: Concepts and Clinical Practice (8th ed., Vol. 2, pp. 1487-1491). Philadelphia: Elsevier Saunders.
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.