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Munchausen’s syndrome and related factitious disorders
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
In ICD-10 (World Health Organisation, 1992), factitious disorder is included under the category of disorders of adult personality and behaviour in which the person, in the absence of confirmed physical or mental disorder, disease or disability, feigns symptoms repeatedly and consistently. Individuals with this pattern of behaviour also show other marked abnormalities of personality and relationships. At the time of writing, it also occurs in the beta draft of ICD-11 under the category F68 “Other disorders of adult personality and behaviour” as F68.1 “Intentional production or feigning of symptoms or disabilities, either physical or psychological [factitious disorder].” The beta draft gives the following elaboration: “The patient feigns symptoms repeatedly for no obvious reason and may even inflict self-harm in order to produce symptoms or signs. The motivation is obscure and presumably internal with the aim of adopting the sick role. The disorder is often combined with marked disorders of personality and relationships.” In the beta draft, both factitial dermatitis (included elsewhere under L98.1) and persons feigning illness (with obvious motivation) (included under Z76.5) are excluded from F68.1.
Evaluation Process Guidelines
Published in Harold V. Hall, Joseph G. Poirier, Detecting Malingering and Deception, 2020
Harold V. Hall, Joseph G. Poirier
The literature offers very sparse validation of factitious disorders as an independent diagnosis as opposed to a specific variation of malingering. Rogers, Bagby, and Vincent (1994) compared structured inventory for reported symptoms (SIRS) records of subjects (Ss) diagnosed with factitious disorders with primarily psychological symptoms to 25 suspected malingerers. There were no consistent differences between the records of the two groups. The authors suggested use of the factitious disorder diagnosis only on a provisional basis.
Paper 3: Answers
Published in Sabina Burza, Beata Mougey, Srinivas Perecherla, Nakul Talwar, Practice Examination Papers for the MRCPsych Part 1, 2018
Sabina Burza, Beata Mougey, Srinivas Perecherla, Nakul Talwar
False. Malingering is driven by an external incentive such as financial compensation, whereas the subject with factitious disorder assumes a sick role in which the motivation is almost always obscure. Munchausen’s syndrome is classified within the category of factitious disorders. (14)
Organophosphate insecticide poisoning with monocrotophos-induced fabricated illness in a 7-year-old girl with refractory seizures over a 4-year period
Published in Paediatrics and International Child Health, 2022
Chisambo Mwaba, Chalilwe Chungu, Ronald Chola, Kafula Lisa Nkole, Somwe Wa Somwe, Evans Mpabalwani
Over time, the nomenclature has evolved. In the United Kingdom and the United States of America, there is now greater emphasis on catering to the needs of the child who remains a victim, regardless of the motivation underlying the perpetrator’s actions [3,4]. Consequently, the diagnosis can now be made in a child without having to prove deliberate deception or psychological (internal) motivation, and, critically, the diagnosis can be made by healthcare providers as well as mental health professionals. The American Academy of Pediatrics uses the term ‘caregiver-fabricated illness in a child’ (CFIC) to describe the syndrome in the victim and this is the term used in this article. The perpetrator is diagnosed by a mental health professional as having ‘factitious disorder imposed on another’ (FDIA) [4].
Identification of chloramphenicol in human hair leading to a diagnosis of factitious disorder
Published in Clinical Toxicology, 2020
Alice Ameline, Marie Caroline Taquet, Jean-Edouard Terrade, Bernard Goichot, Jean-Sébastien Raul, Pascal Kintz
Chloramphenicol (2,2-dichloro-N-[1,3-dihydroxy-1-(4-nitrophenyl)porpan-2-yl]acetamide) is a bacteriostatic antibiotic of the phenicolated family (Figure 1). The drug is metabolized hepatically to a glucuronide conjugate and excreted rapidly with a half-life of 1.6–3.3 h. During treatment, effective concentrations are achieved at approximately 1 h and are between 10 and 20 mg/L. Toxic concentrations are above 40 mg/L [1]. Treatment with chloramphenicol can have adverse effects, the most serious of which is aplastic anemia, a rare and sometimes fatal disease usually presenting several weeks or months after stopping treatment, which may be associated with an as yet unidentified genetic predisposition [2–5]. Chloramphenicol was removed from the French market in 2008 but is still marketed in other European countries [6,7]. Factitious disorder (previously Munchausen syndrome) is a psychiatric condition in which an individual either simulates or produces symptoms and signs of physical illness in order to attract attention, medical interventions, and compassion [8].
Reliability, validity, and factorial structure of the Turkish version of the Structured Inventory of Malingered Symptomatology (Turkish SIMS)
Published in Psychiatry and Clinical Psychopharmacology, 2019
Ferhat Can Ardic, Samet Kose, Mustafa Solmaz, Filiz Kulacaoglu, Yasin Hasan Balcioglu
When malingering was considered in differential diagnosis, clinicians are expected to ascertain the motivations and level of conscious awareness that accompany symptoms reported by individuals rather than identifying certain diagnostic criteria during presentation [5]. Among the differential conditions to be considered in the malingering cases are factitious disorders, in which the motivation is internal such as assuming a sick role and somatoform disorders, in which the condition and the presentation of symptoms are not viewed as intentional. Different types of external motivations might have an impact on the presentation of malingering, including avoiding military duty or work, efforts to obtain financial compensation, efforts to evade criminal prosecution, and obtaining drugs [5].