[Are artificial disorders common in palliative care? A Case report]

Area of Science:

• Palliative Care Medicine
• Psychiatry
• Medical Ethics

Background:

• Palliative care focuses on symptom management (pain, nausea, fatigue) and requires thorough patient assessment.
• Increasingly, palliative care encounters psychiatric conditions like depression and anxiety, necessitating enhanced physician preparedness.
• Distinguishing between organic disease progression and psychiatric etiology, such as factitious disorders, is a diagnostic challenge.

Observation:

• This case report explores how palliative care specialists can differentiate between symptoms of malignant or neurological progression and those of psychiatric origin, specifically factitious disorders.
• The study investigates the incidence of factitious disorders within the palliative care setting.
• A case study highlights the rarity, yet possibility, of encountering factitious symptoms in palliative care.

Findings:

• Factitious disorders, while uncommon, can present in palliative care patients.
• Awareness of potential psychiatric origins, even when indicated in referrals, is crucial for accurate diagnosis.
• The case underscores the importance of comprehensive differential diagnosis in palliative care.

Implications:

• Palliative care physicians must maintain a high index of suspicion for factitious disorders.
• Thorough review of patient history, including referral and discharge summaries, is essential.
• Ensuring palliative care is the most appropriate treatment requires ruling out underlying psychiatric conditions presenting as physical symptoms.