3,351 results match your criteria Factitious Disorder


False lithium toxicity secondary to lithium heparin test tube: A case report and review.

Ment Health Clin 2020 May 7;10(3):90-94. Epub 2020 May 7.

This case demonstrates a false elevation of serum lithium concentrations that can occur when blood samples are collected using lithium heparin (green-top) tubes. The patient was a 58-year-old female on chronic lithium therapy for bipolar disorder who presented to the emergency department following an overdose of 5 unidentified medications. The patient was overly sedated and exhibited paradoxical laughter, slurred speech, and mild abdominal pain. Read More

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http://dx.doi.org/10.9740/mhc.2020.05.090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213950PMC

An adolescent girl with signs and symptoms of anaphylaxis and negative immunologic workup: a case report.

J Med Case Rep 2020 Apr 17;14(1):49. Epub 2020 Apr 17.

Department of Psychiatry, University of California San Diego, San Diego, CA, 92121, USA.

Background: The increasing incidence of allergies and allergic reactions among children and adults has become a major public health concern. The etiology of allergic reactions can often be confirmed based on a detailed history and supportive testing. However, there are cases where the underlying factors are more complex and difficult to identify. Read More

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http://dx.doi.org/10.1186/s13256-020-02371-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164209PMC

Munchausen Syndrome.

South Med J 2020 Apr;113(4):198-200

From the University of Louisville School of Medicine, Louisville, Kentucky.

Munchausen syndrome is a factitious disorder that is difficult to diagnose and treat. This article clarifies points for clinical recognition and management of patients with this condition. Patients with this condition often are dramatic and provide false and/or exaggerated symptoms or information. Read More

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http://dx.doi.org/10.14423/SMJ.0000000000001079DOI Listing

Overlooking Feigning Behavior May Result in Potential Harmful Treatment Interventions: Two Case Reports of Undetected Malingering.

J Forensic Sci 2020 Mar 23. Epub 2020 Mar 23.

Forensic Psychology Section, University of Maastricht, The Netherlands.

Clinicians tend to overestimate their ability to recognize feigning behavior in psychiatric patients, especially if it concerns patients who have been admitted for observation. Feigning can be either externally motivated (e.g. Read More

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http://dx.doi.org/10.1111/1556-4029.14320DOI Listing

Factitious disorder commonly presents as dermatitis factitia: A U.S. population-based study.

Gen Hosp Psychiatry 2020 May - Jun;64:129-130. Epub 2020 Feb 6.

Department of Internal Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, United States of America.

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http://dx.doi.org/10.1016/j.genhosppsych.2020.02.003DOI Listing
February 2020

[Hypoglycaemia and seizures in a 32-year-old woman with maple syrup urine disease].

Internist (Berl) 2020 Mar;61(3):321-325

Innere Medizin, Stiftungsklinik Weißenhorn, Klinik der Kreisspitalstiftung, Weißenhorn, Deutschland.

A 32-year-old woman with maple syrup urine disease presented with recurring episodes with hypoglycaemia and cerebral seizures. In most cases a connection to the inborn metabolic disorder is assumed, resulting in symptomatic treatment. Due to these treatments invasive procedures are required. Read More

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http://dx.doi.org/10.1007/s00108-019-00726-7DOI Listing

A case report of Munchausen syndrome presenting with bleeding from ear: a rare factitious disorder.

J Pak Med Assoc 2020 Jan;70(1):168-170

Department of Otolaryngology, Patel Hospital, Karachi, Pakistan.

Munchausen syndrome is a rare psychiatric illness that includes mimicking a group of medical conditions, in which a person repeatedly harms him or herself or falsely misinterprets any medical condition when he or she is not actually sick, in order to achieve health care attention. Underdiagnosis of this syndrome leads to irrelevant use of medical assets. Here, we document an interesting and rare case of a young girl presented in the outpatient department of the Otolaryngology department of Patel Hospital with episodes of bleeding from her ear, which is a rare presentation of Munchausen syndrome. Read More

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http://dx.doi.org/10.5455/JPMA.72100DOI Listing
January 2020

Identification of chloramphenicol in human hair leading to a diagnosis of factitious disorder.

Clin Toxicol (Phila) 2020 Jan 8:1-5. Epub 2020 Jan 8.

Institut de Médecine Légale, Strasbourg, France.

Chloramphenicol (2,2-dichloro-N-[1,3-dihydroxy-1-(4-nitrophenyl)porpan-2-yl]acetamide) is a bacteriostatic antibiotic of the phenicolated family, used in the past to treat meningitis, plague, cholera, or typhoid fever. Treatment with chloramphenicol can have life threatening side effects, the most serious of which is aplastic anemia, which may be fatal. For this reason, the antibiotic was removed from the French market in 2008. Read More

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http://dx.doi.org/10.1080/15563650.2019.1708375DOI Listing
January 2020

Challenges Associated With Vascular Access Needs of Patients With Factitious Disorder.

Authors:
Janet P McMillan

J Infus Nurs 2020 Jan/Feb;43(1):39-46

Forrest General Home Care and Hospice, Hattiesburg, Mississippi. Janet P. McMillan, DSN, APRN, PMHNP-BC, ACHPN, CNE, is certified as both a psychiatric nurse practitioner and an advanced hospice and palliative care nurse. She draws her experience from her extensive nursing career, which began in 1982. For the past 20 years, Dr McMillan has worked in the home health and hospice fields providing care to patients with mental health needs.

Factitious disorder, formerly known as Munchausen syndrome, is a type of mental illness in which patients fabricate symptoms to gain attention or sympathy. When considering a patient with factitious disorder as a candidate for infusion therapy, the clinician must be aware of the challenges associated with providing an invasive treatment to high-risk patients while promoting safety. Read More

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http://dx.doi.org/10.1097/NAN.0000000000000353DOI Listing
December 2019

Avoiding Unnecessary Repeat Laboratory Testing.

Cureus 2019 Oct 9;11(10):e5872. Epub 2019 Oct 9.

Pulmonary & Critical Care, University of Missouri Healthcare, Columbia, USA.

We present a 44-year-old Caucasian female with a history of diabetes mellitus admitted to the intensive care unit (ICU) for refractory hypoglycemia with an initial blood glucose of 39 mg/dl. The initial evaluation included a random insulin level, C-peptide, Hemoglobin A1c, and a sulfonylurea screen that were ordered when the patient's blood sugar was 39 mg/dL. She was discharged after demonstrating euglycemia. Read More

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http://dx.doi.org/10.7759/cureus.5872DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834110PMC
October 2019

Fabricated or induced illness in a child.

Br J Nurs 2019 Nov;28(20):1288-1290

Staff Nurse, Paediatric Critical Care, Royal Manchester Children's Hospital.

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http://dx.doi.org/10.12968/bjon.2019.28.20.1288DOI Listing
November 2019

Malignant but not maleficent: acute leukaemia as a possible explanation of disease and death in vampire victims.

Ir J Med Sci 2020 May 12;189(2):627-631. Epub 2019 Nov 12.

Department of Haematology, Odense University Hospital, J.B. Winsløws Vej 4, DK 5000, Odense, Denmark.

Background: A considerable amount of research has been put into the explanation of the origin of the vampire myth by focussing on possible symptoms of the vampire; however, very little attention has been given to the victims.

Aims: To elucidate whether the myth of vampire victims follows the course of disease of acute leukaemia.

Method: We studied three classical vampire novels published 1819-1897, focusing on 8 victims and their symptoms. Read More

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http://dx.doi.org/10.1007/s11845-019-02124-2DOI Listing
May 2020
3 Reads

The clenched fist syndrome: case report of a clinical rarity of special interest for psychiatrists and hand surgeons.

BMC Psychiatry 2019 11 8;19(1):349. Epub 2019 Nov 8.

Division of Surgery II, Witten-Herdecke University, Wuppertal, Germany.

Background: The Clenched Fist Syndrome (CFS) is a type of a psychiatric disorder, in which the patients show flexion finger contractures. Although no organic etiology can be identified, the syndrome in most cases presents with pain and paradoxical stiffness.

Case Presentation: We, herein, report the case of a 52-year old woman with a 6-month history of progressive hand flexion contracture and intermittent numbness in the first 3 fingers, mimicking carpal tunnel syndrome. Read More

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http://dx.doi.org/10.1186/s12888-019-2348-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839091PMC
November 2019

Evaluation and Management of Factitious Disorder Imposed on Another.

J Clin Psychol Med Settings 2019 Oct 14. Epub 2019 Oct 14.

Department of Psychiatry & Behavioral Sciences, Stanford University Medical School, Stanford, CA, USA.

Munchausen by proxy refers to an individual who abusively and compulsively falsifies physical, psychiatric or developmental disorders in a child or adult victim in order to satisfy a psychological need. Factitious disorder imposed on another refers to the psychopathology in the abuser. Psychologists in medical settings may: (1) identify patients they come to suspect as being victims or perpetrators of MBP, (2) conduct or assist in clinical or forensic evaluations; (3) offer recommendations for clinical case management, and/or (4) provide treatment or referrals. Read More

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http://dx.doi.org/10.1007/s10880-019-09668-6DOI Listing
October 2019
1 Read

Medical Child Abuse Hidden in Pediatric Settings: Detection and Intervention.

J Clin Psychol Med Settings 2019 Oct 10. Epub 2019 Oct 10.

Quincy College, Quincy, MA, USA.

Medical child abuse, sometimes referred to as Munchausen Syndrome by Proxy or childhood factitious disorder, poses significant diagnostic, intervention, and ethical issues for medical and mental health practitioners alike. Psychologists working in pediatric hospitals and medical clinics should remain mindful of the health and ethical risks posed by these conditions, which are challenging to detect and treat. The surreptitious nature of the conditions and hazards they pose require an integrated medical, psychological, and child protective response. Read More

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http://dx.doi.org/10.1007/s10880-019-09666-8DOI Listing
October 2019
9 Reads

Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses, and Medical Uncertainty.

Healthcare (Basel) 2019 Oct 8;7(4). Epub 2019 Oct 8.

Retired, Plantation, FL, USA. Retired Associate Professor of Pharmacology and Physiology, NJ Medical School, Newark, NJ 07103, USA.

There is often difficulty differentiating between psychosomatic, somatopsychic, multisystem illness, and different degrees of medical uncertainty. Uncommon, complex, and multisystem diseases are commonly misdiagnosed. Two case histories are described, and relevant terms differentiating psychosomatic, somatopsychic, and multisystem illnesses are identified, reviewed, and discussed. Read More

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http://dx.doi.org/10.3390/healthcare7040114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955780PMC
October 2019
1 Read

Health providers induced iatrogenic delusions of infestation.

Clin Cosmet Investig Dermatol 2019 11;12:679-681. Epub 2019 Sep 11.

Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.

Patients that suffer from factitial dermatosis mutilate their skin, often lacking any consciousness of self-injury, attributing the resulting lesions to spontaneous development. The case hereby described shows how the health providers' interventions led a patient from a baseline undiagnosed factitious disorder to frank delusions of infestation with , and a relentless search for antibiotic treatments. We highlight the need for educating health practitioners on the characteristics of psycho-cutaneous disorders. Read More

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http://dx.doi.org/10.2147/CCID.S218894DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6745403PMC
September 2019
2 Reads

Dying to be Ill: Munchausen meets warfarin overdose.

J Family Med Prim Care 2019 Aug 28;8(8):2741-2743. Epub 2019 Aug 28.

Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA.

Patients with severe coagulopathy related to vitamin K deficient proteins can be associated with surreptitious ingestion of vitamin K antagonists. Our patient presented acutely with extensive ecchymosis, gingival bleeding and hematuria. Her initial PT and PTT were prolonged and INR was >12. Read More

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http://dx.doi.org/10.4103/jfmpc.jfmpc_453_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753795PMC
August 2019
3 Reads

An interesting case of factitious pseudomembranous conjunctivitis.

Indian J Ophthalmol 2019 10;67(10):1693-1694

Department of Vitreoretinal Services, Prabha Eye Clinic and Research Centre, Bengaluru, Karnataka, India.

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http://dx.doi.org/10.4103/ijo.IJO_223_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786135PMC
October 2019

The other face of illness-deception: Diagnostic criteria for factitious disorder with proposed standards for clinical practice and research.

Clin Neuropsychol 2020 Apr 19;34(3):454-476. Epub 2019 Sep 19.

The Chicago School of Professional Psychology, Xavier University, New Orleans, LA, USA.

This paper aims to develop diagnostic criteria for factitious disorder (FD) and a heuristic for research by creating standards for delineating criterion groups.: Both FD and malingering are conceptualized within a rubric of illness-deception. The history of FD research was compared to the research history on malingering. Read More

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http://dx.doi.org/10.1080/13854046.2019.1663265DOI Listing
April 2020
3 Reads

Malingering, conversion and factitious disorders. The emotional and monetary costs to the healthcare delivery system.

J Community Hosp Intern Med Perspect 2019 5;9(4):369-370. Epub 2019 Sep 5.

Mayo Clinic Health System Mankato.

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http://dx.doi.org/10.1080/20009666.2019.1643221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735308PMC
September 2019
3 Reads

Munchausen syndrome mimicking refractory subcutaneous abscess with bacteremia, diagnosed by repetitive element sequence-based polymerase chain reaction: a case report.

J Med Case Rep 2019 Sep 12;13(1):287. Epub 2019 Sep 12.

Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.

Background: Rapid diagnosis and appropriate treatment of Munchausen syndrome is important not only for the patient but also for health care workers because a delay in diagnosis can worsen patients' clinical outcomes, and result in a substantial medical cost.

Case Presentation: A young and previously healthy 24-year-old Japanese woman, a nurse, presented with complaints of refractory abscess on her left upper limb for 3 months. A physical examination on admission revealed low-grade fever and a subcutaneous abscess in her left forearm. Read More

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https://jmedicalcasereports.biomedcentral.com/articles/10.11
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http://dx.doi.org/10.1186/s13256-019-2212-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6740024PMC
September 2019
3 Reads

Painless purple streaks on the arms and chest.

Cutis 2019 Jul;104(1):E8-E9

Department of Dermatology, Division of Pediatric Dermatology, Johns Hopkins University School of Medicine, Baltimore, USA.

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Self-induced skin conditions: differential diagnosis and management.

Br J Gen Pract 2019 09 29;69(686):464-465. Epub 2019 Aug 29.

Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire.

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http://dx.doi.org/10.3399/bjgp19X705449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715494PMC
September 2019

Early death in Munchausen syndrome: A case report.

Clin Case Rep 2019 Aug 20;7(8):1473-1477. Epub 2019 Jun 20.

Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy.

This case contributes to raising awareness and understanding of the complex clinical presentations of Munchausen syndrome (MS). Education of staff to the seriousness and genuineness of this disorder should be implemented, especially in hospital units, in order to detect such complex clinical situations quickly and accurately, preventing iatrogenic risks. Read More

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http://dx.doi.org/10.1002/ccr3.2254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6692973PMC
August 2019
8 Reads

Factitial panniculitis as a manifestation of self-imposed factitious disorder.

Dermatol Online J 2019 May 15;25(5). Epub 2019 May 15.

Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL.

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. Read More

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May 2019
16 Reads

A Systematic Approach to the Detection of False PTSD.

J Am Acad Psychiatry Law 2019 Aug 10;47(3):325-334. Epub 2019 Jun 10.

Dr. Matto is Assistant Clinical Professor of Psychiatry, Dr. McNiel is Professor of Clinical Psychology, and Dr. Binder is Professor of Psychiatry in the Department of Psychiatry, University of California, San Francisco. This article was presented, in part, at the 47th annual meeting of the American Academy of Psychiatry and the Law, October 27-30, 2016, in Portland, Oregon.

Posttraumatic stress disorder (PTSD) can occur after a traumatic experience and can cause severe symptoms that interfere with a person's psychological, physical, interpersonal, occupational, and social functioning. It is important to accurately identify genuine cases of PTSD and, as part of the differential diagnosis, to rule out instances of false PTSD. False PTSD diagnoses can adversely affect treatment planning, resource management, and research. Read More

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http://dx.doi.org/10.29158/JAAPL.003853-19DOI Listing
August 2019
9 Reads

Self-induced dermatoses: A great imitator.

Clin Dermatol 2019 May - Jun;37(3):268-277. Epub 2019 Jan 11.

Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

The self-induced dermatoses represent about 2% of dermatology patient visits, and include the recurrent body-focused repetitive behaviors (BFRB) (skin-picking or excoriation disorder, trichotillomania, onychophagia and onychotillomania), dermatitis artefacta, and features of other psychiatric disorders, for example, secondary to excessive grooming in body dysmorphic disorder, skin picking in delusional infestation, or secondary to self-harm in depressive disease. Among the BFRBs, onychophagia and onychotillomania are most likely to be associated with lesions that mimic other dermatologic conditions (eg, nail psoriasis, lichen planus, vasculitis, onychomycosis, melanoma). Dermatitis artefacta (DA) describes lesions that are self-inflicted with the intention of assuming a sick role in the absence of obvious external rewards. Read More

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http://dx.doi.org/10.1016/j.clindermatol.2019.01.006DOI Listing
December 2019
29 Reads

[Pitfall cryothermic dermatitis artefacta].

Hautarzt 2019 Nov;70(11):883-887

Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.

We present four clinicopathological correlated cases of young patients with cryothermic dermatitis artefacta. They were initially misdiagnosed as primary bullous dermatoses or fixed drug eruptions. Cryothermic dermatitis artefacta can imitate authentic dermatoses such as linear IgA bullous dermatosis, herpes virus infection, bullous pemphigoid or fixed drug eruption. Read More

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http://dx.doi.org/10.1007/s00105-019-4443-3DOI Listing
November 2019
13 Reads

Severe hypokalemia secondary to abuse of β-adrenergic agonists in a pediatric patient: Case report.

J Bras Nefrol 2019 May 30. Epub 2019 May 30.

Nephology Service, Fundació Puigvert, Barcelona, España.

This study reports a case of a 13-year-old male with a 3-year history of severe and intermittent hypokalemia episodes of unknown origin, requiring admission to the intensive care unit (ICU) for long QT syndrome (LQTS), finally diagnosed of redistributive hypokalemia secondary to the abuse of β-adrenergic agonists in the context of a probable factitious disorder. Read More

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http://dx.doi.org/10.1590/2175-8239-JBN-2019-0020DOI Listing
May 2019
6 Reads

Dermatitis artefacta mimicking cutaneous vasculitis: case report and literature overview.

Reumatologia 2019 29;57(2):106-108. Epub 2019 Apr 29.

Department of Internal Medicine, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil.

A 31-year-old Caucasian woman with a history of anxiety disorder presented with chronic ulcerative lesions of the skin in arms and legs, treated initially as cutaneous vasculitis, evolving with relapsing during corticosteroid tapering, was diagnosed, after thorough investigation and no organic disease found, with dermatitis artefacta - a self-inflicted harm due to psychological disorders. Dermatitis artefacta is a rare condition, more frequent in women, in which traumatic skin lesions are caused by the patient him/herself, over accessible parts of the body, due to personality disorders. Clinicians should be aware of this alternative aetiology, especially as a differential diagnosis for refractory cutaneous vasculitis. Read More

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http://dx.doi.org/10.5114/reum.2019.84816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532111PMC
April 2019
16 Reads

Repeated Enterocutaneous Fistula in a Munchausen Syndrome Patient.

Case Rep Gastroenterol 2019 Jan-Apr;13(1):173-177. Epub 2019 Apr 9.

Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.

Munchausen syndrome is a rare type of mental disorder in which the patient fakes illness to gain attention and sympathy. Patients may lie about symptoms, make themselves appear sick, or make themselves purposely unwell. We describe a case of repeated enterocutaneous fistula in Munchausen syndrome. Read More

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http://dx.doi.org/10.1159/000499443DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6514499PMC
April 2019
9 Reads

Delusional health beliefs.

Authors:
Peter May

Med Leg J 2019 Jun 20;87(2):73-76. Epub 2019 May 20.

Delusional health beliefs can be difficult and costly for practitioners to diagnose and manage. Patients often deny that mental distress is the cause of their illness, when it may be the most significant factor. Such patients can be relentless in their pursuit of a physical cause and go from doctor to doctor to find one who agrees with them, using up significant NHS resources. Read More

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http://journals.sagepub.com/doi/10.1177/0025817219845512
Publisher Site
http://dx.doi.org/10.1177/0025817219845512DOI Listing
June 2019
12 Reads

Psychological Treatment of Factitious Disorder Imposed on Another/Munchausen by Proxy Abuse.

J Clin Psychol Med Settings 2020 Mar;27(1):139-149

Departments of Psychiatry & Biobehavioral Sciences; Pediatrics, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Semel 48-241, Los Angeles, CA, 90024-1759, USA.

The purpose of this article is to propose management and treatment protocols for family members impacted by MBP abuse. A brief review of psychopathology, co-morbidities, MBP risk level, treatment outcomes, and rationale for treatment is presented, followed by detailed guidance regarding psychological treatment and management. We propose five components of psychotherapy for abusers, best remembered by using the acronym of ACCEPTS: ACknowledgement, Coping, Empathy, Parenting, Taking charge, and Support. Read More

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http://dx.doi.org/10.1007/s10880-019-09630-6DOI Listing
March 2020
17 Reads

Unexplained destructive nasal lesions in half-brothers: A possible case of Munchausen syndrome by proxy.

Int J Pediatr Otorhinolaryngol 2019 Aug 25;123:75-78. Epub 2019 Apr 25.

Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical Branch, Galveston, TX, USA.

Munchausen syndrome by proxy (MSBP) is a condition diagnosed when a caregiver knowingly fabricates or inflicts illness on another for his/her own gain. Typical cases of MSBP detected by otolaryngologists involve facial trauma or otologic injury, while descriptions involving the nose are rare. Destructive nasal lesions have a broad differential diagnosis and may require visits to numerous specialists, placing strain on both the patient and the healthcare system. Read More

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http://dx.doi.org/10.1016/j.ijporl.2019.04.029DOI Listing
August 2019
40 Reads

Triparesis: an unusual presentation of factitious disorder.

BMJ Case Rep 2019 May 9;12(5). Epub 2019 May 9.

Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Factitious disorder (FD) has diverse presentations but neurological presentation is unusual. In this report, we discuss a case of FD who presented with triparesis, that is, weakness of both lower limbs and right upper limb. Diagnosis of FD was made after detailed clinical evaluation, review of past medical records that revealed extensive evaluation to rule out physical illness, and inability to find any associated stressful event or material gain associated with illness. Read More

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http://dx.doi.org/10.1136/bcr-2018-226869DOI Listing
May 2019
7 Reads

Thyroid detectives: on the trail of Munchausen's syndrome.

BMJ Case Rep 2019 Apr 29;12(4). Epub 2019 Apr 29.

Endocrinology and Metabolism, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India.

Thyrotoxicosis factitia, a disorder frequently seen in young or middle-aged women with psychological disorders, most commonly results from surreptitious ingestion of excess thyroid hormones. In most patients, diagnosis is relatively straightforward and depends on the demonstration of biochemical thyrotoxicosis, suppressed endogenous thyroid function and absence of clinical features of underlying thyroid disease. However, at times, confounding factors can make the diagnosis particularly challenging and necessitate the investigating physician to don the detective's cap to get to the root of the problem. Read More

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http://dx.doi.org/10.1136/bcr-2018-226087DOI Listing
April 2019
70 Reads

Dopamine dysregulation syndrome in non-Parkinson's disease patients: a systematic review.

Australas Psychiatry 2019 Oct 29;27(5):456-461. Epub 2019 Apr 29.

Consultant Psychiatrist, Consultation Liaison Psychiatry Department, Gosford Hospital, Gosford, NSW, Australia.

Objectives: To explore the presence of dopamine dysregulation syndrome in non-Parkinson's disease patients receiving dopamine replacement therapy.

Methods: Electronic searches were conducted of Medline, Embase, PsycINFO and PreMedline to capture articles related to dopamine misuse or factitious disorder combined with the presence of dopamine replacement therapy or a non-Parkinson's disease population. In total, 430 articles were reviewed and studies that addressed dopamine dysregulation syndrome in non-Parkinson's disease patients were included. Read More

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http://dx.doi.org/10.1177/1039856219839476DOI Listing
October 2019
8 Reads

The Incidence of Diagnosis of Munchausen Syndrome, Other Factitious Disorders, and Malingering.

Behav Neurol 2019 3;2019:3891809. Epub 2019 Mar 3.

Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

Background: Systematic studies on factitious disorders and malingering in large populations are rare. To address this issue, we performed a nationwide epidemiological study in Norway on the incidence of these diagnoses in an unselected patient population. In particular, we tried to confirm the diagnoses and to estimate the contribution of Munchausen syndrome to the spectrum of factitious disorders. Read More

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http://dx.doi.org/10.1155/2019/3891809DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421757PMC
July 2019
23 Reads

Dermatitis artefacta: self-inflicted genital injury.

Int Med Case Rep J 2019 18;12:71-73. Epub 2019 Mar 18.

Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia,

Background: The term dermatitis artefacta (factitious dermatitis, pathomimia) is reserved for the most severe variant of factitious physical disorder and is characterized by exaggerated lying (pseudologia fantastica), sociopathy, geographic wandering (peregrinating) from hospital to hospital, and seeking to be in the patient role.

Objective: This report aims to give attention to the importance of accurate and detailed history, and conducting an appropriate physical examination in patients with life-threatening diseases when the underlying cause is not apparent. The diagnosis of dermatitis artefacta must always be upheld. Read More

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http://dx.doi.org/10.2147/IMCRJ.S192522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429999PMC
March 2019
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Factitious Hyperlithemia: Why Lithium Heparin Blood Tubes may get you in Trouble.

Klin Padiatr 2019 07 1;231(4):212-213. Epub 2019 Apr 1.

Hospital Clinic de Barcelona, Neonatology, Barcelona, Spain.

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http://dx.doi.org/10.1055/a-0868-0074DOI Listing
July 2019
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Factitious thyrotoxicosis: how to find it.

Diagnosis (Berl) 2020 May;7(2):141-145

Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Background Although the most common cause of thyrotoxicosis is Graves' disease, the determination of the cause of thyrotoxicosis is important for establishing appropriate management. Diagnosis of surreptitious ingestion of thyroid hormones or factitious thyrotoxicosis often presents a difficult challenge especially in a patient with previously diagnosed Graves' disease. The objective of this report was to demonstrate various approaches to support the diagnosis of factitious thyrotoxicosis. Read More

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http://dx.doi.org/10.1515/dx-2019-0015DOI Listing
May 2020
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Medical Child Abuse: An Unusual "Source" of Vaginal Bleeding.

J Pediatr Adolesc Gynecol 2019 Jun 25;32(3):334-336. Epub 2019 Mar 25.

Section of Adolescent Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Electronic address:

Background: Medical child abuse (MCA) is challenging to diagnose. Although young children are often affected, adolescents can be victims through caregiver coercion. Presentation is highly variable. Read More

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http://dx.doi.org/10.1016/j.jpag.2019.03.003DOI Listing
June 2019
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The Mayo Clinic Experience With Psychogenic Purpura (Gardner-Diamond Syndrome).

Am J Med Sci 2019 05 7;357(5):411-420. Epub 2019 Feb 7.

Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Division of Hematopathology and Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota. Electronic address:

Background: The objective of this study was to describe presentation, natural history, management and long-term outcomes of patients with psychogenic purpura (PP), also known as Gardner-Diamond Syndrome.

Methods: In this retrospective study, records of patients with a diagnosis of PP seen at Mayo Clinic, Rochester from 1976 to 2016 were reviewed. Available literature regarding PP was also comparatively reviewed. Read More

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http://dx.doi.org/10.1016/j.amjms.2019.02.002DOI Listing
May 2019
7 Reads