Factitious Disorder-Experience at a Neuropsychiatric Center in Southern India

Dahale, Ajit Bhalchandra; Hatti, S.; Thippeswamy, Harish; Chaturvedi, Santosh K.

doi:10.4103/0253-7176.127253

Cited by 13 publications

(8 citation statements)

References 11 publications

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“…The prevalence of FD varies according to several factors. For example, the type of patient population, study setting, and clinical suspicion and awareness manifested by the healthcare professional can influence the prevalence of this disorder [ 13 ]. In the present study, out of the patients attending KAMC from January 2015 to December 2020, only seven patients were assigned the diagnosis of FD.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, out of the patients attending KAMC from January 2015 to December 2020, only seven patients were assigned the diagnosis of FD. According to previous studies, the prevalence of FD among psychiatry inpatients varied between 0.5 and 8% [ 13 ]. We believe that our results showed a relatively low prevalence rate, which may be attributed to a reduced awareness of FD among clinicians and due to the difficulty in the diagnosis of the disorder [ 7 , 11 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…In terms of occupation, research suggests that FD is more common in females who work in healthcare institutions [ 13 , 15 ]. According to Yates and Feldman’s systematic review, nursing was the single most common occupation among patients with FD [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Factitious Disorder in Seven Patients: A Saudi Experience

Qasim¹,

Samman²,

Alalwan³

et al. 2021

Cureus

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BackgroundFactitious disorder (FD) is a psychiatric disease where signs and symptoms are produced, falsified, or exaggerated consciously in the absence of clear external motivations. Through needless medical visits, costly investigatory testing, and potentially long hospital stays, patients with FD waste valuable time and resources, which affects both the patient and the healthcare system. It can be very challenging for physicians who have never encountered patients with FD to recognize them promptly as symptoms of FD vary greatly. MethodologyThis was a retrospective study of patients diagnosed with FD attending King Abdulaziz Medical City in Riyadh, Saudi Arabia, a tertiary care military hospital and one of the most prominent academic and referral medical institutions in the country. Using the BESTCare health information system, we reviewed patients' electronic health records from January 2015 to December 2020. The diagnosis of FD was based on the International Classification of Diseases and Related Health Problems 10th edition. ResultsA total of seven patients were included in the study, of whom five (71%) were males and two (29%) were females. Of the total seven patients, three were 21 years old and younger, one was 38 years old, and three were 56 years old and older. Three (43%) patients were married and four (57%) were single. In terms of occupation, three (43%) patients were retired, one (14%) worked in a private company, one (14%) was unemployed, and two (29%) were students. A total of four (57%) patients initially presented to the Emergency Department (ED), and only three (43%) presented to the outpatient clinics. Induced disease or injury was found in five (71%) patients. Induced skin injury was found in four (57%) patients. Counseling and psychotherapy were only offered to one (14%) patient. ConclusionsFD remains a rare psychiatric condition that is difficult to recognize. Despite a small sample size, FD in the present study showed a male predominance, affecting patients of all age groups. About half of the patients presented initially to the ED. Induced disease or injury was the most commonly reported pattern of clinical presentation. Induced skin injury was the most common clinical presentation found in around half of the patients. We believe that the number of FD patients in the present study is likely underreported and is expected to be higher. This highlights the need for better awareness of FD among physicians in different medical fields. We emphasize that there is a need for better professional training in the identification of FD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Factitious Disorder in Seven Patients: A Saudi Experience

Qasim¹,

Samman²,

Alalwan³

et al. 2021

Cureus

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“…Practical difficulties in the diagnosis of psychiatric disorders in people with FD include factors such as atypical, dramatic, vague, and inconsistent presentation of symptoms in different medical specialties. Suspicion is the key point to diagnose FD (5). Although it may be upsetting to suspect a patient of violating the basic and implicit patient-doctor contract, which is based on mutual trust, it seems necessary to maintain an index of suspicion for factitious causes of medical and psychiatric diagnoses, even in children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

Factitious Disorder Presenting with Stuttering in Two Adolescents: The Importance of Psychoeducation

Bolat

Yalcin

2017

Arch Neuropsychiatr

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A factitious disorder (FD) is a diagnostic entity in which patients intentionally act physically or mentally ill without obvious benefits and without being consciously aware of a clear underlying motive. Most pediatric FD cases have been reported as Munchausen syndrome by Proxy; however, pediatric disease symptoms can also be intentionally falsified by child and adolescent patients. To our knowledge, in the medical literature, an FD patient presenting with stuttering has not been previously reported. In this case report, we aimed to discuss the diagnosis and treatment process of FDs in children and adolescents by reporting the cases of two FD patients presenting with stuttering according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition. Both patients improved with psychoeducation and early confrontation.

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“…[ 1 ] FD or DA has to be distinguished from malingering by “sick role” seeking commonly seen in DA in contrast to external incentives acting as the motivating factor in malingering. [ 2 ] We report a case of DA in a 38-year-old female with localized alopecia of the right half of eyebrow and anterior part of right side of the scalp.…”

Section: Introductionmentioning

confidence: 99%

Dermatitis artefacta presenting with localized alopecia of right eyebrow and scalp

et al. 2016

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Dermatitis artefacta (DA) and trichotemnomania are self-inflicted dermatoses often preceded by psychosocial stressful events. A 38-year-old female presented with sudden loss of hair in the right frontal area along with discoloration and edema of skin. On examination, there was complete loss of hair involving the right frontal area and the lateral half of right eyebrow with skin over that area appearing scalded, edematous, bruised, and discolored. After a detailed medical and psychological evaluation, a clinical diagnosis of DA with trichotemnomania was made. A tactful multidisciplinary approach is essential in managing such patients as outright referral to a psychiatrist could be counterproductive.

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Factitious Disorder-Experience at a Neuropsychiatric Center in Southern India

Cited by 13 publications

References 11 publications

Factitious Disorder in Seven Patients: A Saudi Experience

Factitious Disorder in Seven Patients: A Saudi Experience

Factitious Disorder Presenting with Stuttering in Two Adolescents: The Importance of Psychoeducation

Dermatitis artefacta presenting with localized alopecia of right eyebrow and scalp

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