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Factitious disorder comorbid with bipolar I disorder. A case report
Antonio Del Casale1, Stefano Ferracuti, Chiara Rapinesi
1Sapienza University of Rome, NESMOS Department (Neuroscience, Mental Health and Sensory Organs), School of Medicine and Psychology, Sant'Andrea Hospital of Rome, Rome, Italy. antonio.delcasale@uniroma1.it
Forensic Science International
|January 31, 2012
Summary
This case study highlights a woman with bipolar I disorder and factitious disorder, whose symptoms evolved to involve her daughter. The study analyzes how mood phases impact her factitious symptoms and medical-seeking behavior.
Area of Science:
- Psychiatry
- Clinical Psychology
Background:
- Factitious disorder is a serious mental health condition where individuals feign illness.
- Bipolar I disorder is a mood disorder characterized by manic and depressive episodes.
Observation:
- A 37-year-old woman with bipolar I disorder developed factitious disorder with physical and psychological symptoms.
- Her condition escalated to Munchausen by proxy, involving her daughter.
- Poor adherence to treatment and lack of improvement were noted.
Findings:
- Factitious symptoms varied with mood phases: somatic complaints in depressive phases and medical intervention-seeking in manic/mixed phases.
- The patient manipulated clinicians for surgical interventions.
- Co-occurrence of these disorders presents complex clinical and forensic challenges.
Implications:
- Clinicians must recognize patients' potential to feign illness.
- Psychiatric consultation is crucial before invasive procedures.
- Awareness of symptom fluctuation based on mood is vital for accurate diagnosis and management.
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