[Suspected factitious disorder: identifying self-inflicted wounds in plastic surgery]

Area of Science:

• Psychiatry
• Plastic Surgery
• Medical Psychology

Background:

• Factitious disorders involve patients feigning or inducing illness, causing significant physical harm and healthcare system strain.
• Characterized by chronic symptoms, frequent medical changes, and invasive procedures, often leading to misdiagnosis.
• Clinical complexity and lack of awareness can result in delayed or incorrect treatment.

Purpose of the Study:

• To review common characteristics of factitious disorders.
• To outline effective treatment strategies for factitious disorders.
• To improve diagnostic accuracy and therapeutic outcomes for affected individuals.

Main Methods:

• Selective literature review.
• Analysis of clinical case reports from a university plastic surgery clinic.

Main Results:

• Suspected factitious disorders warrant limiting invasive procedures and seeking psychiatric/psychosomatic consultation.
• An empathic physician-patient relationship and psychotherapy aid in diagnosis acceptance and treatment adherence.
• Avoiding treatment termination is possible with appropriate support.

Conclusions:

• Recognizing indicators in medical history, findings, and behavior is key for early identification and treatment.
• Factitious disorders should be considered in differential diagnoses across medical specialties.
• A central reporting register could aid diagnosis and improve future therapy.