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https://www.readbyqxmd.com/read/28622821/the-therapeutic-discharge-an-approach-to-dealing-with-deceptive-patients
#1
John B Taylor, Scott R Beach, Nicholas Kontos
OBJECTIVE: Patients with factitious disorder or malingering behaviors pose particular problems in acute care settings. We sought to describe a manner to effectively discharge these patients and keep further harm, iatrogenic or otherwise, from being inflicted. METHOD: Once an indication has been identified, the therapeutic discharge can be carried out in a stepwise fashion, resulting in a safe discharge. We outlined how to prepare for, and execute, the therapeutic discharge, along with preemptive consideration of complications that may arise...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28578365/self-inflicted-eye-injury
#2
Mohammed A Gogandy, Abdulqader Aljarad, Sabah S Jastaneiah, Abdullah M Alfawaz
Individuals with a factitious ocular disorder feign or exaggerate having an eye injury or intentionally produce an eye injury so as to assume the role of a sick person. We report two cases of self-inflicted ocular injury using needle-like foreign bodies and razor that represent possible diagnoses of Munchausen syndrome. Both patients presented with different clinical pictures that misguided the clinical diagnosis and delayed proper management. Although self-inflicted ocular injuries are rare, ophthalmologists should be aware of the possibility of their existence, particularly when caring for patients with psychiatric conditions...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28573061/pseudologia-fantastica-in-the-emergency-department-a-case-report-and-review-of-the-literature
#3
Robyn Thom, Polina Teslyar, Rohn Friedman
Psychiatrists commonly encounter deception in the emergency department. This article presents the case of a patient who presents to the emergency department with an unusual and elaborate web of deceptions along multiple themes including feigning medical illness, multiple losses, and grandiose academic and athletic achievements. We review the clinical characteristics of pseudologia fantastica and discuss how this patient's constellation of malingering, factitious disorder, and personality disorder suggests this diagnosis...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28566966/factitious-disorder-presenting-with-stuttering-in-two-adolescents-the-importance-of-psychoeducation
#4
Nurullah Bolat, Özhan Yalçin
A factitious disorder (FD) is a diagnostic entity in which patients intentionally act physically or mentally ill without obvious benefits and without being consciously aware of a clear underlying motive. Most pediatric FD cases have been reported as Munchausen syndrome by Proxy; however, pediatric disease symptoms can also be intentionally falsified by child and adolescent patients. To our knowledge, in the medical literature, an FD patient presenting with stuttering has not been previously reported. In this case report, we aimed to discuss the diagnosis and treatment process of FDs in children and adolescents by reporting the cases of two FD patients presenting with stuttering according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition...
March 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/28468741/factitious-disorders-in-dermatology-still-a-challenging-diagnosis
#5
Nicolas Kluger
No abstract text is available yet for this article.
May 3, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/28451707/-factitious-disorders
#6
H-P Kapfhammer
Patients with factitious disorders intentionally fabricate, exaggerate or feign physical and/or psychiatric symptoms for various open and covert psychological reasons. There are many issues regarding the diagnostic state and classification of factitious disorders. Both the categorical differentiation of and clinical continuum ranging from somatoform/dissociative disorders to malingering are being controversially debated. Epidemiological studies on the frequency of factitious disorder meet basic methodological difficulties...
April 27, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28411771/psychocutaneous-disease-clinical-perspectives
#7
REVIEW
Helena Kuhn, Constance Mennella, Michelle Magid, Caroline Stamu-O'Brien, George Kroumpouzos
Psychocutaneous disease, defined in this review as primary psychiatric disease with skin manifestations, is commonly encountered in dermatology. Dermatologists can play an important role in the management of psychocutaneous disease because patients visit dermatology for treatment of their skin problems but often refuse psychiatric intervention. This review describes common psychocutaneous syndromes, including delusional, factitious, obsessive-compulsive and related, and eating disorders, as well as psychogenic pruritus, cutaneous sensory (pain) syndromes, posttraumatic stress disorder, and sleep-wake disorders...
May 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28374307/medical-child-abuse-munchausen-syndrome-by-proxy-multidisciplinary-approach-from-a-pediatric-gastroenterology-perspective
#8
REVIEW
Andrea Z Ali-Panzarella, Tamika J Bryant, Hannah Marcovitch, Jeffery D Lewis
PURPOSE OF REVIEW: We highlight the need for a multidisciplinary approach to the diagnosis of medical child abuse, also known as factitious disorder imposed on another (FDIA) or Munchausen syndrome by proxy (MSP), and review our experience focusing on the variety of symptoms that often present to the pediatric gastroenterologist many months before the diagnosis is made. RECENT FINDINGS: Recent literature on medical child abuse, mostly case reports, is markedly limited, highlighting a need for increased research on this topic...
April 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28352494/the-wandering-woman-a-case-study-of-catatonia-vs-factitious-disorder
#9
Jennifer Wh Wong, Steven R Williams
A 61-year-old woman with an unknown psychiatric history presented with mutism, stupor, negativism, and withdrawn behavior. She was admitted to the psychiatric unit for what appeared to be catatonia. Medical records were not readily available. A comprehensive evaluation did not uncover any medical etiology. Lorazepam was ineffective at consistently reversing her catatonic symptoms. During week three of hospitalization, she was given olanzapine with subsequent improvement in her negativism. Several physicians believed her catatonic symptoms were feigned given multiple episodes of spontaneous purposeful movement when she was not under the direct supervision of staff...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28276597/an-international-perspective-on-feigned-mental-disabilities-conceptual-issues-and-continuing-controversies
#10
Thomas Merten, Richard Rogers
In forensic contexts, an increased prevalence of feigned symptom presentations should be expected, although it will probably vary by the context and specific forensic issue. Forensic experts should examine this possibility proactively while maintaining a balanced perspective that actively considers clinical data for both feigning and genuine responding. Psychological measures and standardized methods developed for feigning and other response styles can facilitate these often complex determinations. The current article provides an international perspective on the issue of feigned mental disabilities...
March 2017: Behavioral Sciences & the Law
https://www.readbyqxmd.com/read/28250565/multimodal-hallucinations-in-schizophrenia-and-its-management
#11
Vijaya Kumar, Virupakshappa Bagewadi, Dayanand Sagar, Shivarama Varambally
A cluster of symptoms including hallucinations characterizes schizophrenia. Hallucinations that occur in more than one modality simultaneously and emanate from a single source are called multimodal hallucinations (MMHs). The occurrence of simultaneous hallucinations as the major manifestations of a psychiatric disorder often was dismissed as factitious disorder or malingering. Conversely, MMHs have been reported in severe mental disorders including schizophrenia. Here, we report MMH in two patients of treatment-resistant schizophrenia and its successful management with clozapine...
January 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28129926/panniculitis-a-summary
#12
REVIEW
Mark R Wick
The diagnosis of panniculitis is felt to be a confusing topic by some pathologists. This summarical article presents inflammatory diseases of the subcutis in a systematic fashion, based on whether they are centered on fibrovascular septa or the adipose lobules, and whether morphologic vasculitis is present or not. Septocentric, non-vasculitis disorders include erythema nodosum, panniculitis that follows the use of "biological" therapeutic agents, lipodermatosclerosis, post-irradiation panniculitis, morphea profunda, and necrobiosis lipodica profunda...
May 2017: Seminars in Diagnostic Pathology
https://www.readbyqxmd.com/read/27990636/factitious-disorder-in-a-patient-claiming-to-be-a-sexually-sadistic-serial-killer
#13
Christopher A Fischer, Mace Beckson, Park Dietz
Factitious disorder involves the conscious simulation of psychological or physiological symptoms of illness, for the purpose of fulfilling the unconscious desire to be taken care of or to assume the "sick role." Typically patients with factitious disorder simulate conditions that are designed to arouse feelings of empathy in care providers with the intention to engage them in caretaking. However, patients might also simulate conditions that arouse revulsion or rejection and still meet full diagnostic criteria for factitious disorder...
May 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27982450/self-embedding-behavior-in-adults-a-report-of-two-cases-and-a-systematic-review
#14
Victor S Mannarino, Débora C S Pereira, Wagner S Gurgel, Carolina B F Costa, Alexandre M Valença, Leonardo F Fontenelle, Mauro V Mendlowicz
Self-embedding behavior (SEB) is the repeated insertion of sharp objects, such as needles or pins, into the soft tissues of abdomen, limbs, and other body parts. In this study, two cases of SEB were reported and the scientific worldwide literature reviewed. Thirty-two cases of SEB were identified through systematic searches in the main bibliographic databases. Mean age was 35 years (SD = 8.97). Just over two-thirds of the patients were female. Although the number of embedded objects could be as high as 200, major clinical and surgical complications were uncommon and mortality was null...
December 16, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27810112/assessing-older-adults-in-civil-litigation-cases
#15
Eileen A Kohutis
With the population aging, the legal and mental health systems need to be prepared for cases that involve older adults beyond the customary matters of guardianship and competency. Assessing older adults with the current tests raises concerns because these measures may not be adequately normed for this age group. Malingering, factitious disorders, and somatoform disorders are discussed due to health-related issues of normal aging. These topics complicate the assessment procedure and need consideration because they may affect the claimant's performance or symptom presentation...
November 2016: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/27761196/factitious-disorder-presenting-with-attempted-simulation-of-fournier-s-gangrene
#16
Joseph Tseng, Peter Poullos
Fournier's gangrene is a severe polymicrobial necrotizing fasciitis of the perineal, genital, or perianal regions. The classic presentation is severe pain and swelling with systemic signs. Crepitus and cutaneous necrosis are often seen. Characteristic CT findings include subcutaneous gas and inflammatory stranding. Unless treated aggressively, patients can rapidly become septic and die. Factitious Disorder is the falsification of one's own of medical or psychological signs and symptoms. Many deceptive methods have been described, from falsely reporting physical or psychological symptoms, to manipulating lab tests, or even injecting or ingesting foreign substances in order to induce illness...
September 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/27754802/diagnosis-of-abcc8-congenital-hyperinsulinism-of-infancy-in-a-20-year-old-man-evaluated-for-factitious-hypoglycemia
#17
Amichai Gutgold, David J Gross, Benjamin Glaser, Auryan Szalat
Context: Hypoglycemia is a rare event in healthy adults, and the differential diagnosis includes many diseases, some of which are rare and easily missed. Design, Setting, Description: A 20-year-old male military paramedic was referred to our emergency department for investigation of recurrent hypoglycemia episodes during the previous months. Factitious hypoglycemia was excluded, and organic hyperinsulinemic hypoglycemia was diagnosed by the findings from a prolonged fast...
February 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27752984/identifying-and-managing-malingering-and-factitious-disorder-in-the-military
#18
Sebastian Schnellbacher, Heather O'Mara
Malingering is the intentional fabrication of medical symptoms for the purpose of external gain. Along similar lines as malingering, factitious disorder is the intentional creation or exaggeration of symptoms, but without intent for a concrete benefit. The incidence of malingering and factitious disorder in the military is unclear, but likely under reported for a variety of reasons. One should be aware of potential red flags suggesting malingering or factitious disorder and consider further evaluation to look for these conditions...
November 2016: Current Psychiatry Reports
https://www.readbyqxmd.com/read/27739333/factitious-hyperkalemia-in-hematologic-disorders
#19
Árpád Lábadi, Ágnes Nagy, Árpád Szomor, Attila Miseta, Gábor L Kovács
No abstract text is available yet for this article.
February 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/27719876/neurophysiologic-studies-of-functional-neurologic-disorders
#20
REVIEW
M Hallett
Functional neurologic disorders are largely genuine and represent conversion disorders, where the dysfunction is unconscious, but there are some that are factitious, where the abnormality is feigned and conscious. Malingering, which can have the same manifestations, is similarly feigned, but not considered a genuine disease. There are no good methods for differentiating these three entities at the present time. Physiologic studies of functional weakness and sensory loss reveal normal functioning of primary motor and sensory cortex, but abnormalities of premotor cortex and association cortices...
2016: Handbook of Clinical Neurology
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