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Introduction and purpose Munchausen syndrome by proxy is a factitious disorder characterized by the search for and induction of somatic symptoms, the falsification of laboratory results, and even the mutilation of a loved one, usually a child, by a parent or caregiver. Paediatricians often only have information about the child's condition from an interview with the child's guardian, so it is very important to differentiate feigned disorders from real, sometimes difficult to diagnose, cases of illness. We may suspect them if the parent reports unusual symptoms in the child, insinuates further treatments and hospital stays, has above-average knowledge of medical terminology, and is aggressive towards the staff. Prominent among the causes of Munchausen syndrome by proxy are first and foremost the desire to focus the parent/carer's attention on themselves and the expectation of recognition for their care and concern for the child. Methods and materials The following review was based on articles from the PubMed and Google Scholar databases. Key search terms included munchausen syndrome, munchausen syndrome by proxy, treatment, diagnosis, paediatric condition falsification, factitious disorder. Conclusions Due to the nature of this disorder, physicians of different specialities may come across it during their practice. Increasing their knowledge on this topic and the effects of Munchausen syndrome by proxy will allow the correct diagnosis to be established and appropriate psychiatric therapy with psychological care to be introduced, as well as protecting children who are victims of the actions of their caregivers. [ABSTRACT FROM AUTHOR]

Objective: Factitious disorder is characterized by a pattern of abnormal behavior in which patients deliberately produce, falsify, or exaggerate physical and/or psychological symptoms that have no, or little, organic basis, to assume the sick role. In the context of a factitious disorder, depression can be both a feigned disease and an associated comorbidity. We performed a systematic review to provide an overview of the relationship between factitious disorder and depression, describe the prevalence of depression in factitious disorder, and identify factors that can contribute to the development of depression in patients suffering from factitious disorder. Methods: A literature search was performed using the electronic databases PubMed, EMBASE and Cochrane Library following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were eligible for inclusion in this review if they investigated factitious disorder or Munchausen Syndrome with comorbid depression. Results: Depression was found to be highly prevalent in factitious disorder, affecting around 30% of the samples. Risk factors for depression in factitious disorder included having suffered from childhood and adulthood traumatic experiences and having a history of psychosocial problems. Conclusion: The treatment of factitious disorder is challenging and requires a multidisciplinary team approach. Given the high levels of depression in patients with factitious disorder, we recommend to always screen for depression once a factitious disorder is diagnosed. [ABSTRACT FROM AUTHOR]

False claims of having an intersex condition have been observed in print, video, Internet media, and in live presentations. Claims of being intersexed in publicly accessible media were examined and evidence that they were false was considered sufficiently conclusive in 37 cases. Falsity was most often detected due to medical implausibility and/or inconsistency, but sometimes also using information from third-party or published sources. The majority, 26/37, of cases were natal males; 11/37 were natal females. Almost all (34/37) were transgendered, living, or aspiring to live, in their non-natal sex or as socially intergender. The most commonly claimed diagnosis was ovotesticular disorder ("true hermaphroditism") due to chimerism, an actually uncommon cause of authentic intersexuality. Motivations for pretending to be intersexed were inferred from statements and behaviors and were varied. Some such pretenders appear to be avoiding the external or internalized stigma of an actual transgendered condition. Some appear, similarly to persons with factitious disorder, to be seeking attention and/or the role of a sick, disadvantaged, or victimized person. Some showed evidence of paraphilia, most frequently autogynephilia, and, in several cases, paraphilic diaperism. For some cases, such claims had been accepted as authentic by journalists or social scientists and repeated as true in published material. [ABSTRACT FROM AUTHOR]

The Authors present a case illustrating factitious disorder, who was previously diagnosed as schizophrenia for 2 years, with a comorbidity of depressive disorder (unspecified) and obsessive-compulsive disorder. The factitious presentation involved exaggeration of symptoms, demanding and challenging behavior towards medical personnel, prolonging of sick role by refusing necessary intervention. Diagnosis of schizophrenia complicated patient's condition when poly-pharmacy was introduced. The element of deception too provided difficulty in clinician to identify other comorbid psychiatric issue of depression and Obsessive Compulsive Disorder (OCD), with the suspicion of Borderline Personality Disorder. We emphasize the importance of recognizing possible signs of deception through looking at the atypical presentation throughout the treatment course and consequences following the misdiagnosis. [ABSTRACT FROM AUTHOR]

Introduction and purpose Munchausen syndrome by proxy is a factitious disorder characterized by the search for and induction of somatic symptoms, the falsification of laboratory results, and even the mutilation of a loved one, usually a child, by a parent or caregiver. Paediatricians often only have information about the child's condition from an interview with the child’s guardian, so it is very important to differentiate feigned disorders from real, sometimes difficult to diagnose, cases of illness. We may suspect them if the parent reports unusual symptoms in the child, insinuates further treatments and hospital stays, has above-average knowledge of medical terminology, and is aggressive towards the staff. Prominent among the causes of Munchausen syndrome by proxy are first and foremost the desire to focus the parent/carer’s attention on themselves and the expectation of recognition for their care and concern for the child. Methods and materials The following review was based on articles from the PubMed and Google Scholar databases. Key search terms included munchausen syndrome, munchausen syndrome by proxy, treatment, diagnosis, paediatric condition falsification, factitious disorder. Conclusions Due to the nature of this disorder, physicians of different specialities may come across it during their practice. Increasing their knowledge on this topic and the effects of Munchausen syndrome by proxy will allow the correct diagnosis to be established and appropriate psychiatric therapy with psychological care to be introduced, as well as protecting children who are victims of the actions of their caregivers.

ObjectiveFactitious disorder is characterized by a pattern of abnormal behavior in which patients deliberately produce, falsify, or exaggerate physical and/or psychological symptoms that have no, or little, organic basis, to assume the sick role. In the context of a factitious disorder, depression can be both a feigned disease and an associated comorbidity. We performed a systematic review to provide an overview of the relationship between factitious disorder and depression, describe the prevalence of depression in factitious disorder, and identify factors that can contribute to the development of depression in patients suffering from factitious disorder.MethodsA literature search was performed using the electronic databases PubMed, EMBASE and Cochrane Library following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were eligible for inclusion in this review if they investigated factitious disorder or Munchausen Syndrome with comorbid depression.ResultsDepression was found to be highly prevalent in factitious disorder, affecting around 30% of the samples. Risk factors for depression in factitious disorder included having suffered from childhood and adulthood traumatic experiences and having a history of psychosocial problems.ConclusionThe treatment of factitious disorder is challenging and requires a multidisciplinary team approach. Given the high levels of depression in patients with factitious disorder, we recommend to always screen for depression once a factitious disorder is diagnosed.

BackgroundOral hypoglycemic agents are a frequent cause of hypoglycemia in nondiabetic people. Here, we report a case of recurrent hypoglycemia caused by glipizide, in which diagnosis was delayed because of a combination of delayed hypoglycemic agent screening and low sensitivity of the hypoglycemic agent screening panel used.Case reportA 66-year-old woman repeatedly presented with symptomatic hypoglycemia. At the first presentation, the serum glucose level was 40 mg/dL (2.2 mmol/L), C-peptide level was 13.1 ng/mL (0.8-3.1 ng/mL), proinsulin level was 96.9 pmol/L (

Patients with factitious disorder imposed on self (FDIS) seek medical care for deliberately falsified problems. Although a large amount of work has been published, the scientific literature lacks robust data on FDIS. The present study aimed to estimate the annual mean of in-hospital FDIS codings in France, describe the sociodemographic characteristics of subjects with FDIS, assess healthcare utilisation and medical nomadism, and describe the pathologies most frequently associated with FDIS. Subjects with at least one coding of FDIS in French health insurance databases between January 1, 2009, and December 31, 2017 were included. Subjects younger than 18 years of age at the time of first coding were excluded from the study. Sociodemographic data of subjects and diagnoses associated with the first coding of FDIS were collected. Healthcare utilisation and medical nomadism were analysed descriptively from one year before to one year after the first FDIS coding. 2232 subjects were included, representing an average of 248 new in-hospital FDIS codings per year. The subjects included were 58.2% female. The mean age at diagnosis was 48.5 years. In the year following the first coding of FDIS, 1268 subjects (56.8%) were re-hospitalised at least once, including 159 (7.1%) with at least one new coding for FDIS. From one year before to one year after the first coding of FDIS, 66% of the subjects included had received at least one prescription for benzodiazepines, 58.3% for antidepressants, and 42.6% for antipsychotics. Our findings bring new data working towards a better understanding of FDIS. The consumption of psychotropic drugs is particularly frequent in patients with FDIS. [ABSTRACT FROM AUTHOR]

Physicians sometimes face difficulty identifying underlying diseases of some signs and symptoms created by individuals intentionally but without any apparent practical gain. This case report presents the clinical profile of a woman aged 22 years with a history of recurrent bleeding from the oral cavity since childhood, which has recently been worsened and now involves bleeding from the nose, eye, ear, and umbilicus. However, no physical or laboratory abnormalities could be identified. She had mental trauma in her childhood. After a comprehensive assessment that included a medical history, observation, physical examination, and psychiatric evaluation, she was diagnosed with Munchausen syndrome, which is a psychological condition where people pretend to be ill or deliberately produce symptoms of illness in themselves. She was treated with pharmacotherapy and psychotherapy and discharged from the hospital bleeding-free, which persisted till several follow-up visits.

Abstract Background There is a high prevalence of somatoform disorders and medically unexplained symptoms. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder. The case presented demonstrates the impact on disability benefits and the subsequent psychosocial repercussions of misdiagnosing between a factitious disorder and a somatoform disorder. Case presentation A 42-year-old Caucasian woman worked as a 100% fiduciary accountant until the age of 32 when she was placed on medical leave due to persistent trigeminal neuralgia. Afterward, she developed total blindness, not explained by a physiological process, accompanied by distress in a crucial emotional context. We evaluated the patient for a revision of a disability income after a diagnosis of factitious disorder with severe consequences such as disability income suspension and family conflict. Our psychiatric examination concluded the diagnoses of pain disorders related to psychological factors and a dissociative neurological symptom disorder with visual disturbance. Conclusions Blindness not explained by a physiological process may accompany trauma and psychological distress. Differentiating this pathology from factitious disorder or simulation is essential from an insurance medicine point of view, but also for its treatment.

Factitious disorder represents a category of mental disorders still insufficiently known and diagnosed, which requires more studies and research for a better understanding of all its social and psychological characteristics and to discover a treatment that is as suitable for patients. Also, the positive diagnosis is often very difficult to be establish and not only psychiatrists are involved, but also other medical specialties or health professionals, with an impact on the general population by all the consequences and the costs. This is because patients can present only with physical symptoms or only with mental symptoms or with both. The association with other medical conditions or other mental disorders, which must be diagnosed and treated as early as possible, must also be taken into account. The prognosis is generally reserved, and the therapeutic options are still discussed among the specialists. That's why in this paper we present an overview, regarding the information provided by the specialized literature on this subject. [ABSTRACT FROM AUTHOR]

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Background: There is a high prevalence of somatoform disorders and medically unexplained symptoms. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder. The case presented demonstrates the impact on disability benefits and the subsequent psychosocial repercussions of misdiagnosing between a factitious disorder and a somatoform disorder. Case presentation: A 42-year-old Caucasian woman worked as a 100% fiduciary accountant until the age of 32 when she was placed on medical leave due to persistent trigeminal neuralgia. Afterward, she developed total blindness, not explained by a physiological process, accompanied by distress in a crucial emotional context. We evaluated the patient for a revision of a disability income after a diagnosis of factitious disorder with severe consequences such as disability income suspension and family conflict. Our psychiatric examination concluded the diagnoses of pain disorders related to psychological factors and a dissociative neurological symptom disorder with visual disturbance. Conclusions: Blindness not explained by a physiological process may accompany trauma and psychological distress. Differentiating this pathology from factitious disorder or simulation is essential from an insurance medicine point of view, but also for its treatment. [ABSTRACT FROM AUTHOR]

Factitious disorders and factitious disorders imposed on another are a prevalent encounter during dermatology visits. Here, we present a case of a pediatric patient who presented with ulcer-like lesions that, based on initial biopsy, suggested an immunobullous etiology. Further exploration revealed her underlying psychiatric disorder. Dermatologists play an integral role in recognizing and initiating "nervous system" management to establish a level of trust with the patient that will ultimately allow bridging to psychiatric care. The case discussed here serves as an example of the successful diagnosis and treatment of a pediatric psychiatric patient by raising clinical suspicion, using investigative techniques, employing separate interviews and the Patient Health Questionnaire-9, and sensitively addressing the relationship between the patient, guardian, and provider within the dermatology clinic.

In recent years, some neurologists reconsidered their approach to Medically Unexplained Symptoms and proposed Functional Neurologic Disorders (FND) as a new entity, claiming that neurology could offer alternative treatment options to the psychotherapies provided in psychiatry settings. FNDs, for this purpose, should include only the disorders listed as Conversion from the Somatic Symptom and Related Disorders (SSRD) group. The present review analyzes the rationale of this position and challenges the arguments provided for its support. The review also discusses the systematization of these disorders as provided by public health systems. It outlines risks stemming from economic support and public funding uncertainty, given their negligible epidemiological dimensions resulting from the parcellation of SSRD. The review underlines the unresolved issue of Factitious Disorders, which are in the same SSRD category of the international classification but are, nonetheless, overlooked by the theoretical proponents of the FND entity. Comorbidity with other psychiatric disorders is also analyzed. We propose a model that supports the continuum between different SSRD conditions, including Factitious Disorders. The model is based on the emergence of feigned death reflex and deception from frontal lobe dysfunction. Finally, the paper summarizes the wealth of historical psychiatric and psychodynamic approaches and critical reviews. The study also puts in context the categorization and interpretation efforts provided by the most eminent researchers of the past century. [ABSTRACT FROM AUTHOR]

This paper explores the recent phenomenon of adolescents presenting en masse (both online and in clinical settings) with symptoms seemingly acquired from viewing illness-related content posted by social media influencers. The most frequently reproduced illnesses have included Dissociative Identity Disorder (DID) and Tourette Syndrome. It discusses evidence that the recent spate of new-onset, severe tics are a form of Mass Psychogenic Illness facilitated by social media networks (a phenomenon labeled Mass Social Media Induced Illness). It then suggests that many of those self-diagnosed with DID may be manifesting a similar, technologically-facilitated conversion phenomenon. It then explores another explanatory model: that these simulacra of DID and Tourette Syndrome may also arise via a mechanism more closely resembling social media facilitated Factitious Disorder. Similar presentations, of individuals falsifying cancer, have previously been labeled Munchausen's by Internet. It then proposes an overarching construct, Social Media Associated Abnormal Illness Behavior (SMAAIB), that is agnostic regarding phenomenology. Within this framework, it explores the ways in which de-commodifying attention, connection and care (measured once in appointments and admissions, now in 'likes' and 'shares') and obtaining a full picture of the patient's psychological, sociological and cultural grounding can offer deeper understanding and ultimately a path to wellness. [ABSTRACT FROM AUTHOR]

Factitious disorder imposed on self is characterized by self-induction. Dermatitis artefacta, the cutaneous subtype of factitious disorder imposed on self, can have a variety of atypical presentations. A 36-year-old woman with an extensive past medical history presented with painful nodules on her abdomen, thighs, and arms. Histologic evaluation identified panniculitis with foreign body material seen under polarization. Chart review from previous hospital visits established a history of factitious disorder imposed on self and upon subsequent search of the hospital room, syringes with an unknown substance were found. Factitial panniculitis should be considered in cases with atypical lesions or locations that do not conform to the presentation of organic causes of panniculitis. Management should include a multidisciplinary approach that prioritizes patient safety and establishes a therapeutic patient-provider relationship.

Abstract is missing (Quiz)

In recent years, some neurologists reconsidered their approach to Medically Unexplained Symptoms and proposed Functional Neurologic Disorders (FND) as a new entity, claiming that neurology could offer alternative treatment options to the psychotherapies provided in psychiatry settings. FNDs, for this purpose, should include only the disorders listed as Conversion from the Somatic Symptom and Related Disorders (SSRD) group. The present review analyzes the rationale of this position and challenges the arguments provided for its support. The review also discusses the systematization of these disorders as provided by public health systems. It outlines risks stemming from economic support and public funding uncertainty, given their negligible epidemiological dimensions resulting from the parcellation of SSRD. The review underlines the unresolved issue of Factitious Disorders, which are in the same SSRD category of the international classification but are, nonetheless, overlooked by the theoretical proponents of the FND entity. Comorbidity with other psychiatric disorders is also analyzed. We propose a model that supports the continuum between different SSRD conditions, including Factitious Disorders. The model is based on the emergence of feigned death reflex and deception from frontal lobe dysfunction. Finally, the paper summarizes the wealth of historical psychiatric and psychodynamic approaches and critical reviews. The study also puts in context the categorization and interpretation efforts provided by the most eminent researchers of the past century.

Management of mental health illnesses and needs are important in fostering psychosocial support, interprofessional coordination, and greater adherence to treatment protocols in the field of urology. This can be especially true for mental health conditions that may greatly impact the presentation of a patient in the healthcare setting with urologic symptoms. This review describes the history, epidemiology, pathophysiology, clinical presentation, and treatment of somatic symptom disorder, illness anxiety disorder, compulsive sexual behavior/hypersexuality, factitious disorder, malingering symptoms, and conversion disorder in the realm of urology. Given the newly updated psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, there has been a lack of studies reviewing how these illnesses may present in a urology patient encounter. Additionally, as these mental health illnesses may carry a rare incidence compared to other well-known mental health illness such as generalized depression or generalized anxiety disorder, we have found that the lack of provisions and recognition of the diseases can prolong the timeline for diagnosis and lead to an increased cost in both healthcare and quality of life of patients with these mental health illnesses. This review provides awareness on these mental health conditions which may greatly impact patient history and presentation within the field of urology. Additionally, urologic care providers may have an improved understanding of interdisciplinary management of such illnesses and the common symptoms patients may present with such diseases. [ABSTRACT FROM AUTHOR]

Background: Factitious disorder (FD) is an under-recognized and under-diagnosed mental condition. Healthcare professionals often have challenges to diagnose and treating the disorder. As a result, needless and endless medical resources are recommended to assess and evaluate those affected. FD may present as a physical condition, a psychological disorder, or maybe both depending on the prominent symptoms. However, there is a strong correlation between having FD and psychiatric symptoms. Main Text: FD occurs in early adulthood, with a mean age of onset of 25 years in both genders, although with differing demographic features. The lifetime prevalence of FD imposed on oneself in clinical settings is 1.0%, 0.1% in the overall population (ranging between 0.007% and 8.0%) and occurs more in female health care professionals. FD may make up 0.6%–3.0% of psychiatric referrals, and it accounts for 3-5% of doctor-patient contacts. In actuality, 1-2% of hospital admissions and an average of 6-8% of all psychiatric admissions have been underreported. The study aimed to highlight the signs and symptoms of FD identified in a psychiatry department of a multispecialty center and to increase the awareness of health practitioners. A critical review of the literature was done with an emphasis on psychological symptoms. PubMed, Mendeley, and Google Scholar were thoroughly searched and full-text publications of journals from 2010-2021 were included. Conclusion: FD is a diagnostic puzzle that necessitates adequate, prompt medical attention as well as social support because of the potentially fatal consequence. A stronger patient-therapist relationship can strengthen the patient's conscious self-control to minimize the symptoms; therefore the healthcare provider has to be open-minded. For the diagnostic enigma to be removed and for ease of treatment, additional research, increasing awareness among medical professionals and the general public, accurate evaluation, diagnosis, and psychotherapy should be encouraged. These case studies will contribute to the knowledge base of FD and improve the quality of care.

Background: Oral hypoglycemic agents are a frequent cause of hypoglycemia in nondiabetic people. Here, we report a case of recurrent hypoglycemia caused by glipizide, in which diagnosis was delayed because of a combination of delayed hypoglycemic agent screening and low sensitivity of the hypoglycemic agent screening panel used. Case Report: A 66-year-old woman repeatedly presented with symptomatic hypoglycemia. At the first presentation, the serum glucose level was 40 mg/dL (2.2 mmol/L), C-peptide level was 13.1 ng/mL (0.8-3.1 ng/mL), proinsulin level was 96.9 pmol/L (

Factitious disorder, a disorder characterized by the falsification of symptoms to obtain primary gain, continues to be one of the more challenging cases that psychiatrists encounter. We describe a case of a woman we treated on the medical unit who falsified several of her symptoms but also was diagnosed with Yao syndrome, a disease that can also cause unexplained symptoms such as abdominal pain and fever. We navigate the difficulties in managing this type of patient and comanaging her with medicine and rheumatology. Although the prevalence of factitious disorder is anywhere from 1% to 2% of patients on the medical floor, they typically utilize a disproportionate number of resources. Despite this, the literature is still inconclusive when it comes to the management and treatment approaches. More study is warranted on this complex and burdensome illness. [ABSTRACT FROM AUTHOR]

Background: Medical Child Abuse (MCA) is a severe form of child abuse. In MCA, the caregiver abuses the child by exaggerating, fabricating, simulating, or inducing symptoms, and unnecessary, potentially harmful medical care harms the child. Bleeding is one of the most common manifestations of MCA. Diagnosis of MCA is challenging, and late diagnosis may increase the severity and complications. Once suspected, it is essential to apply all relevant methods of investigation to support and confirm the diagnosis, as soon as possible, as late diagnosis increases the risks., Case Presentation: An 18-month-old boy was referred to the Pediatric Hematology by the Department of the Emergency with multiple admissions in a 2-week period for recurrent said-to-be bleeding episodes from different sites. Previously, he had been investigated for recurrent bleeding episodes in different hospitals for 4 months. In our center, the review of medical history, examination findings, and laboratory results showed some important inconsistencies leading to suspicion of MCA and the mother as the perpetrator. Then he was hospitalized for close observation. During hospitalization, multiple episodes of said-to-be bleeding were reported by the mother, but active bleeding was never observed by any hospital staff. No bleeding foci were detected in the nose or ears, supporting the diagnosis of MCA. After the file was forwarded to the prosecutor's office, the child was taken for institutional care, and no further bleeding was observed after separation from the mother. DNA, which was obtained from a so-called nosebleed during hospitalization, was analyzed and was reported to belong to the mother, confirming the diagnosis., Conclusions: This case report draws attention to timely diagnoses by focusing on inconsistencies in the history and clinical signs and good clinical practices for the management of MCA, with a special emphasis on collecting evidence, including DNA samples, to confirm the diagnosis and help the legal process., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest to disclose., (Copyright © 2024 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Factitious hemoptysis is fairly rare condition, the diagnosis of which can be challenging to physicians. A 40-year-old incarcerated male with hemoptysis for four years had previously undergone a detailed investigation, but the etiology of the hemoptysis could not be determined. The hemoptysis has increased in frequency and quantity, however, numerous diagnostic tests, including radiological imaging and bronchoscopy, has been unable to reveal the localization and etiology of the bleeding. As we were about to diagnose idiopathic hemoptysis, some suspicious behaviors and contradictory statements led us to conduct a psychiatric evaluation, and the patient was subsequently diagnosed with axis two personality disorder and factitious disorder. Factitious hemoptysis is difficult to diagnose and may be confused with idiopathic hemoptysis, and should be considered in patients with hemoptysis in which the location and cause of bleeding cannot be determined after a detailed examination. [ABSTRACT FROM AUTHOR]

Whether health care proxy confirmation or guardianship is sought, however, such court involvement would be unsuccessful unless it could be proven to the court that the patient lacks the cognitive capacity to make his or her own health care decisions; meaning, in essence, that the patient is not able to manipulate the clinical data in a meaningful manner, enabling the patient to his or her condition and proposed treatment. Providers are tasked with providing a patient with sufficient disclosures regarding the patient's condition and proposed treatments, as well as alternatives and options, and patients are tasked with considering that information, asking questions to resolve any confusion, and ultimately deciding whether to accept treatment and, if so, what type. B Text Box 1 b B Derisive Terms for FDIS from the Medical Literature b Artefactual patients Black hole patients Doctor addicts False patients Heartsink patients Hospital hoboes Hospital hoppers Hospital addicts Operation addicts Peregrinating problem patients Professional patients Pseudologues Scalpel addicts Thick-chart patients When FDIS patients are identified and referred to psychiatry, it may be difficult for the referral sources to acknowledge their feelings, even to themselves. The patient is told that the treatment would not be expected to succeed if the patient's illness is factitious in origin but that the patient should anticipate improvement if the illness is biological in origin. [Extracted from the article]

Copyright of Forum Dermatologicum is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ganser syndrome (GS) is one of a few eponyms that have survived in psychiatry until the present day. GS is a little-known and rare disorder. It is most often described as a response to a stressor (e.g. incarceration), that is why it is an important issue in forensic psychiatry. Organic causes are taken into consideration. The basic symptoms of the syndrome are: approximate answers, visual and auditory hallucinations, clouding of consciousness and conversion symptoms. Additionally, patients may perform activities in an awry manner and suffer from insensitivity to painful stimuli. GS is usually acute and subsides spontaneously. Usually patients do not remember they had an episode of the disease. Diagnostic criteria of GS are imprecise and its classification has been changed over the years. GS was not listed in the DSM-5 classification, although in the DSM-IV it was classified as a dissociative disorder. Currently some authors tend to classify it rather as a factitious disorder. WHO (ICD-10 and ICD-11) classifies GS as a dissociative and conversion disorder, which seems to be appropriate in the light of current knowledge. The presented case report describes a patient with a nearly identical pattern of full-blown GS, which occurred twice. The symptoms appeared shortly after the patient was incarcerated. The course of the disorder was chronic and recurrent. The patient was insensitive to pain stimuli. Somatic causes were excluded in the diagnostic process. [ABSTRACT FROM AUTHOR]

Factitious Disorder is characterized by fabricating physical or psychological symptoms, injuring or inducing the illness with the intent of deception. Factitious Disorder Imposed on Another is mimicking physical or mental, misleading symptoms, injuring or causing the disease on another. In this disorder, behaviors of deception are obvious, even without any extrinsic reward. It is a severe form of child abuse which leads to high levels of mortality and morbidity. It is stated in the literature that raising awareness of physicians about the disorder can reduce and even sometimes prevent the mortality and morbidity. Multidisciplinary approach is of great significance for the process to be carried out properly and for the disorder to be detected. Turkey suffers from the lack of multidisciplinary teams of physicians who can study and treat such a disorder. It is clear that the judicial system in the country is ignorant of such cases, does not usually commence legal proceedings and cannot prevent the child abuse. This article aims to extensively discuss the biopsychosocial and psychodynamic features of the concepts of factitious disorder and the factitious disorder imposed on another and undertakes to set a course for these concepts in the light of literature research and recent information on the issue, considering the multidisciplinary teamwork conducted by the Commission on Evaluation, Research and Treatment of Child Abuse, clinical experiences and a wide range of concept research included in the literature.

Introduction: About 1% of psychiatric consultations are concerned with a factitious disorder. Unlike malingering, factitious disorder is a special psychiatric disorder that should be taken into consideration by the medical staff. Case Presentation: This case reports a woman with fever and epistaxis as a primary clinical manifestation of a factitious disorder which was diagnosed and treated after further investigation and psychiatric consultation. Conclusions: Procrastination of diagnosis usually leads to an increase in the length of stay for unnecessary clinical and paraclinical investigations. The purpose of this case presentation was to raise the issue of psychiatric problems and their importance alongside physical problems. [ABSTRACT FROM AUTHOR]

The formation of a post-appendicectomy fistula is rare but devastating. Major etiological factors include leakage from the appendiceal stump, neoplasm of the appendix and/or cecum, infection, inflammatory bowel disease, and distal obstruction. The management of enterocutaneous fistula involves enteral nutrition, drainage, antibiotic coverage, as well as surgical excision and segmental resection of the involved bowel. Here we present a case where a young female suffered from refractory enterocutaneous fistula after appendicectomy. Despite extensive treatments, her symptoms persisted and contradicted with objective test results. Therefore, a diagnosis of factitious disorder was suspected. After questioning, she finally admitted to having applied feces to her wound to fake fistula. It was estimated that the lifetime prevalence of factitious disorder in the general population was 0.1%, which warrants the awareness of clinicians.

Pediatric presentations of factitious disorder (Munchausen syndrome) remain underdiagnosed and poorly understood compared to adult cases. The purpose of this study is to review the current literature on child and adolescent factitious disorder in order to better understand the differences between pediatric and adult presentations of this disorder. We also present the case of an adolescent girl with factitious disorder; her hospital course draws attention to the excessive healthcare expenditures and risk of iatrogenic complications associated with this diagnosis. We utilized MEDLINE and Google Scholar databases to conduct our review. Despite the limited number of high-quality studies analyzing pediatric presentations of factitious disorder, our review yielded several important findings. Studies suggest that the general acceptance of somatization as a common way for young people to manifest emotional stress may explain the under-diagnosis of this disorder in pediatric populations. Studies also highlighted differences in the clinical characteristics of factitious disorder when patients are stratified by age; most notably, younger patients are more willing to admit intentional falsifications when confronted and more likely to accept treatment, making them a potentially more effective target for intervention. [ABSTRACT FROM AUTHOR]

Introduction: It could be challenging for healthcare workers to diagnose patients with factitious disorder who present with rare ophthalmologic manifestations such as haemolacria, because of the unavailability of adequate literature and associated guidelines. The present case report aims to fulfill this knowledge gap. Case Presentation: A 20‐year‐old tribal illiterate married female patient with symptoms of bleeding episodes from her left eye was admitted to the hospital. An extensive workup was done for diagnosing possible bleeding disorders but all the parameters were normal. Later on, she was diagnosed with factitious disorder presenting haemolacria after sufficient evidence at the psychiatric unit observations. The patient was treated accordingly, counseled and discharged, but lost‐out to follow‐ups. Practical Implications: The present case is reported from a developing country, Pakistan, for the first‐time may help in diagnosing patients suffering from factitious disorder with unusual ophthalmologic problems. [ABSTRACT FROM AUTHOR]

Background Medical child abuse describes a child receiving unnecessary, harmful, or potentially harmful medical care at the caretaker's instigation. Objectives To focus on medical child abuse as an entity and emphasize its epidemiology, clinical presentations, prevention, and management. Results In the UK, the annual incidence of medical child abuse in children below one year increased to 3:100,000, while its prevalence in Arabs, including Iraq, is ambiguous due to lack of evidence and improper clinician's awareness. The mean age at diagnosis is 14 months to 2.7 years. Female caregivers are the most common offenders. Clinically, medical child abuse could fit into three stages; falsification of illness story, falsification of illness story and physical signs' fabrication, or induction of illness in children. A successful diagnosis mandates a comprehensive review of medical records to identify discrepancies between caregivers' stories versus clinical findings or investigations. Management requires recognizing abuse, halting it, securing the child's safety, maintaining the family's integrity when possible, and aborting unnecessary lateral referrals within the healthcare system. Conclusion Reported cases of medical child abuse are increasing steadily, while less severe ones go unrecognized. No diagnostic tool can help other than the physician's high index of suspicion. The management follows the same principles applied for other forms of child abuse, while good medical practice ensures its prevention.