Factitious Disorders in the Field of Neurology and Psychiatry

Eckhardt, A

doi:10.1159/000288904

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…Autodestructive syndromes are at times striking for the direct, indirect or combined methods of patient self-manipulation they involve [1,2,3,4,5] and examples have been reported from numerous fields of medicine [6,7,8,9]. …”

Section: Methodsmentioning

confidence: 99%

Autodestructive Syndromes

Kocalevent

Fliege

Rose

et al. 2005

Psychother Psychosom

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Background: The phenomenon ‘autodestructive behaviour’ is becoming an increasingly serious disease and cost factor in a wide range of medical fields. The present paper presents a survey of the literature on autodestructive behaviour, excluding psychotic, substance-induced or organic brain disorders. Starting out with a conceptual overview, the paper goes on to look into the epidemiology of autodestructive behaviour and the forms in which it manifests itself. Method: A literature search was conducted in Medline, Psycinfo and Psyndex using the search terms ‘artifact’, ‘artificially induced’, ‘autodestructive’, ‘self-mutilation’, ‘factitious’, ‘self-harm’, ‘self-induced’, ‘self-inflicted’, ‘self-injuring’ and ‘self-mutilation’ for the period from 1977 to 2003. Results: Five of a total of 18 empirical studies describe the simultaneous occurrence of direct and indirect forms of autodestructive behaviour. Reported prevalence rates range from 0.032% to 9.36%. The ratio of females to males was found to be 2:1 (average age: 31.5 years; SD: 9.3 years); in contrast, the gender ratio was reversed for Munchausen’s syndrome. The case history data presented are patchy and differ in terms of their priorities. We found a large number of codiagnoses, which seems to indicate that personality and dependence disorders, or substance misuse, are characteristic of both direct and indirect forms of autodestructive behaviour. Conclusions: The task at hand is to use a yet-to-be-developed nomenclature and adequately operational diagnostic criteria to work out standardised survey instruments that do justice to the heterogeneity of this disorder complex.

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Section: Methodsmentioning

confidence: 99%

Autodestructive Syndromes

Kocalevent

Fliege

Rose

et al. 2005

Psychother Psychosom

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“…Bunun yanında endokrin, respiratuvar, renal, hematolojik, dermatolojik belirtileri, malignensi ve AIDS gibi hastalıkları taklit eden yakınma ve belirtiler sergileyebilirler. 6,7,8,9 Yapay Bozukluklar Amerikan Psikiyatri Birliği, Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı 4. Baskısında (DSM-IV-TR); daha çok psikolojik belirti ve bulguları olan, daha çok fizik belirti ve bulguları olan, psikolojik ve fizik semptom ve bulguları bir arada olan ve başka türlü adlandırılamayan yapay bozukluklar olmak üzere, dört alt tip olarak sınıflandırılmıştır.…”

Section: Introductionunclassified

Munchausen Hemoptizi: Nadir Görülen Bir Yapay Bozukluk Çeşidi

Altıntaş

Özşahin

2016

TJFMPC

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Munchausen Syndrome defined by Asher in 1951 is named after fictitious Baron Karl FriedrichVon Munchausen.This syndrome is characterized by constituting diseases, pathological lying, and visiting healt care units many times with many hospitalizations. These patients seek attention of healthworkers pretending to be sick when in fact they are not. They try to obtain the care and intimacy from health professionals, which they don't feel they have in daily life They can have the support of physicians because they generally have medical information to a degree to define symptoms. Their medical history is generally full of hard to believe tales. The presented case was a 27-year-old female with three children. She attended the outpatient clinic with complaint of hemoptysis but investigations proved that she created the condition herself by traumatizing her oral mucosa. The etiology of this syndrome which is not fully understood, as well as strategies for differential dignosis is discussed and highlights for management of such patients are underlined in the article Keywords: Factitiousdisorder, Munchausen, hemoptysis ÖZETMunchausen Sendromu, adını Baron Karl Friedrich Von Munchausen'dan alan ve Asher tarafından 1951 yılında tanımlanan bir bozukluktur. Bu sendrom, hastalık oluşturma, patolojik yalan söyleme, sağlık kuruluşlarına çok kez ziyarette bulunma ve sık hastaneye yatma öyküsü ile karakterize bir durumdur. Bu kişiler hasta olmadıkları halde, hasta taklidi yaparak günlük hayatta göremediklerine inandıkları ilgiyi, doktor, hemşire ve diğer görevlilerde bulmaya çalışırlar. Kısmen tıp bilgileri de olduğu için, sağlık çalışanlarını inandıracak kadar belirti tarif edip amaçlarına ulaşabilirler. Hastaların tıbbi özgeçmişleri çoğunlukla inanılması çok güç öyküler ile doludur. Sunulan vaka, 27 yaşında evli ve 3 çocuklu bir kadındı. Ağızdan kan gelmesi yakınması ile başvurmuş, ancak yapılan incelemeler sonucu bu durumu hastanın kendisinin ağız mukozasını travmatize ederek yarattığı belirlenmişti. Makalede, bu sendromun tam olarak bilinmeyen etiyolojisinin tartışılmasının yanı sıra, ayırıcı tanıda akla gelmesi gereken durumlar gözden geçirilmiş ve bu hastaların takibinde önemli olduğu düşünülen noktaların altı çizilmiştir.

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“…Still, deliberate selfharm and factitious disorders are considered to be difficult to understand and to treat [Eisendrath, 1989], as well as difficult to study [Kinsella, 2001] -more than two thirds of the studies on factitious disorders are case reports [Favazza and Conterio, 1988;Feldman et al, 1996Feldman et al, , 2001Fras and Coughlin, 1971;Kinsella, 2001;Klonoff et al, 1983;Pattison and Kahan, 1983;Solyom and Solyom, 1990]. Theoretical models for the explanation of underlying psychopathological mechanisms of self-harm and factitious disorders are often based on psychoanalysis [Eckhardt, 1994;Friedman et al, 1972;Sachsse, 1994]. These psychoanalytic perspectives understand self-harm to be the expression of an extremely negative aspect of the self, which is experienced as weak, impulsive, helpless, unworthy, and guilty and is identified with the body [Eckhardt, 1994;Hirsch, 1994;Sachsse, 1994].…”

Section: Introductionmentioning

confidence: 99%

“…Theoretical models for the explanation of underlying psychopathological mechanisms of self-harm and factitious disorders are often based on psychoanalysis [Eckhardt, 1994;Friedman et al, 1972;Sachsse, 1994]. These psychoanalytic perspectives understand self-harm to be the expression of an extremely negative aspect of the self, which is experienced as weak, impulsive, helpless, unworthy, and guilty and is identified with the body [Eckhardt, 1994;Hirsch, 1994;Sachsse, 1994]. Data to corroborate these concepts are regrettably scarce.…”

Section: Introductionmentioning

confidence: 99%

Patients with Overt or Covert Self-Harm: Differences in Optimism and Self-Efficacy

Fliege¹,

Kocalevent²,

Rose³

et al. 2004

Dermatol Psychosom

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Background: Self-harming behavior seems to aim at reducing states of tension and/or reestablishing a sense of self-control. Following this assumption, it is hypothesized that self-destructive patients, especially those with overt self-harm of the skin, have reduced levels of optimism and self-efficacy. Patients and Methods: 854 general hospital patients referred to a psychosomatic-psychotherapeutic liaison-consultation service or to the outpatient department participated in the study. Using an expert rating assessment, 63 patients exhibiting selfharm (overt or covert) could be identified. For comparison, 63 patients without self-destructive behavior and 63 healthy controls were matched for age and sex. Generalized expectancies were assessed by a validated self-rating questionnaire measuring optimism and self-efficacy. Results: No differences were found between patients with or without self-destructive behavior. Yet, patients with overt self-harm had significantly lower values of optimism and self-efficacy than those who concealed their behavior. We discuss whether the self-efficacy of covertly self-destructive patients might be enhanced by perceived long-term positive effects of their behavior.

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Factitious Disorders in the Field of Neurology and Psychiatry

Cited by 13 publications

References 18 publications

Autodestructive Syndromes

Autodestructive Syndromes

Munchausen Hemoptizi: Nadir Görülen Bir Yapay Bozukluk Çeşidi

Patients with Overt or Covert Self-Harm: Differences in Optimism and Self-Efficacy

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