A treatment program for functional paraplegia/Munchausen syndrome.

Area of Science:

• Psychiatry
• Psychology
• Medical Diagnosis

Background:

• Factitious disorder with physical symptoms presents diagnostic and therapeutic challenges.
• Chronic cases often involve extensive prior medical evaluations.
• Understanding environmental influences is crucial for effective management.

Observation:

• Two patients presented with persistent physical symptoms and a history of frequent medical assessments.
• Diagnosis was established as chronic factitious disorder with physical symptoms (DSM III).
• Environmental factors in hospital and home settings appeared to reinforce the condition.

Findings:

• A novel treatment plan was developed and implemented.
• The plan aimed to remove positive reinforcements contributing to the disorder.
• Crucially, the strategy also focused on preventing patient "loss of face" to maintain engagement.

Implications:

• Successful treatment demonstrates the efficacy of a targeted intervention for complex cases.
• This approach highlights the importance of considering environmental factors in factitious disorder.
• The documented case histories offer valuable insights for clinicians managing similar conditions.