[Self-manipulated disease and Munchausen syndrome in adolescents. A case report]

In recent years factitious disorders have gained increasing significance in all medical specialties although in child psychiatry publications on this topic are rare. In this article these and other somatoform disorders are discussed with reference to a case report on a 14-year-old girl. Psychodynamic aspects of this syndrome are presented and differentiated from simulation. Conversion syndromes and hysterical neurosis and comparisons are made with other publications on this topic. Treatment of these patients, who repeatedly succeed in subjecting themselves to invasive and sophisticated diagnostic procedures is difficult because of minimal compliance. The prognosis is affected by the extent to which changes in personality structure and development of alternative problem-solving mechanisms can be achieved.