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Factitious disorders in a teaching hospital
Annals of Internal Medicine
|August 1, 1983
Summary
This study of factitious disorders in hospitalized patients found diverse presentations, including self-induced infections and simulated illnesses. Confrontation led to improvement in most cases, challenging common assumptions about these conditions.
Area of Science:
- Medicine
- Psychiatry
- Hospital Management
Background:
- Factitious disorders represent a significant challenge in healthcare settings.
- Understanding the spectrum and characteristics of these disorders is crucial for effective patient management.
Observation:
- A 10-year survey identified 41 cases of factitious disorders, including fatal, chronic, severe, and life-threatening conditions.
- Disorders were categorized into self-induced infections, simulated illnesses, chronic wounds, and surreptitious self-medication.
- Patients were predominantly women (39) with a mean age of 33, many in medical professions, and generally lacked major mental disorders.
Findings:
- Most patients did not exhibit characteristics of Munchausen's syndrome, malingering, or sociopathy.
- Confrontation regarding self-induced disorders did not lead to patient elopement or suicidal ideation.
- Despite limited acknowledgment, confrontation resulted in clinical improvement for most patients, with 4 chronic cases becoming asymptomatic.
Implications:
- The identified subgroups have distinct prognostic and management implications.
- Findings suggest that factitious disorders in this cohort differ from typical presentations and assumptions.
- Intervention strategies, such as confrontation, can be effective in improving outcomes for patients with factitious disorders.
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