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FACTITIOUS DISORDER

FACTITIOUS DISORDER. Intentionally produce signs and symptoms of medical and mental disorder Misrepresent their histories and symptoms Objective: assume the role of a patient Compulsive quality; voluntary, deliberate and purposeful behavior. Epidemiology.

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FACTITIOUS DISORDER

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  1. FACTITIOUS DISORDER

  2. Intentionally produce signs and symptoms of medical and mental disorder • Misrepresent their histories and symptoms • Objective: assume the role of a patient • Compulsive quality; voluntary, deliberate and purposeful behavior

  3. Epidemiology • Prevalence in the general population is unknown • Occur more frequent in hospital and health care workers • Females > males

  4. Etiology • Psychosocial Factors: • History of childhood abuse or deprivation • Masochistic personality: seek out painful procedures • Identification: reunite with a relative in a magical way • Borderline PD: poor identity formation and disturbed self-image • Significant defense mechanisms: repression, identification, regression, symbolization

  5. Biological Factors • Brain dysfunction: impaired information processing

  6. Diagnosis and Clinical Features • Diagnostic Criteria: • Intentional production or feigning of physical or psychological s/sxs • The motivation for the behavior is to assume the sick role • External incentives for the behavior is absent

  7. Types: • FD with predominantly Psychological S/Sxs • Depression, hallucinations, dissociative and conversion sxs, bizarre behavior • FD with predominantly Physical S/Sxs • Munchausen Syndrome

  8. 3. FD with Combined Psychological and Physical S/Sxs 4. FD NOS • FD by Proxy: a person intentionally produces physical signs or symptoms in another person who is under the first person’s care; to indirectly assume the sick role or to be relieved of the caretaking role

  9. Differential Diagnosis • Somatoform Disorder • PD: antisocial PD, histrionic PD, borderline PD, schizotypal PD • Schizophrenia • Malingering • Substance abuse • Ganser’s syndrome

  10. Course and Prognosis • Onset: early adulthood • May follow real illness, loss, rejection, or abandonment • Long pattern of successive hospitalizations - knowledgeable about medications and hospitalization • Incapacitating and often produce severe trauma or untowward reactions related to treatment • Prognosis is poor

  11. Treatment • Focus on management rather than on cure • Early recognition • Educate the hospital staff members

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