Materiały źródłowe

• #1 Mental Health: Factitious Disorders

  https://www.webmd.com/mental-health/factitious-disorders

  Factitious disorders are conditions in which a person deliberately and consciously acts as if they have a physical or mental illness when they are not really sick. […] People with factitious disorders deliberately create or exaggerate symptoms of an illness in several ways. […] People with factitious disorders behave this way because of an inner need to be seen as ill or injured, not to achieve a clear benefit, such as financial gain. […] Factitious disorders are considered mental illnesses because they are associated with severe emotional difficulties. […] The first goal of treatment for a factitious disorder is to modify the person’s behavior and reduce their misuse or overuse of medical resources. […] In the case of factitious disorder by proxy, the main goal is to ensure the safety and protection of any real or potential victims.

• #1 What is Munchausen syndrome by proxy?

  https://www.medicalnewstoday.com/articles/167813

  Factitious disorder imposed on another (FDIA) is a mental illness. It causes a person to fabricate illness in a dependent, leading to the dependent receiving unnecessary medical treatment. The person does not do this for financial gain. […] FDIA is a mental health issue. A parent or caregiver with FDIA seeks medical care for a dependent person who does not need it. […] A doctor may suspect FDIA if a parent or caregiver repeatedly seeks medical treatment for a child or another dependent who has unexplained symptoms. […] Various experts can provide treatment to the caregiver and the dependent. […] Treatment may involve psychotherapy and counseling, family therapy, and physical therapy. […] Psychotherapy can help the caregiver identify the reasons for their actions and how to resolve the problem.

• #1 Factitious disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/factitious-disorder/symptoms-causes/syc-20356028

  Factitious disorder is a rare condition that can be hard to diagnose and treat. Help from medical and mental health professionals is critical to prevent serious injury and even death when people with factitious disorder hurt themselves. […] People with factitious disorder may know the risk of injury or even death when they hurt themselves or seek treatment that’s not needed. But they have a hard time managing their behaviors. They also aren’t likely to seek help. Even when they see proof that they’re causing their illness, such as a video, they often deny it and refuse mental health help. […] Recognizing and treating factitious disorder may help avoid potentially dangerous tests and treatments that aren’t needed.

• #1 Factitious Disorders (300.19) | Abnormal Psychology

  https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/factitious-disorders-300-19/

  A. The patient is intentionally producing or pretending to have physical or psychological symptoms or signs of illness. […] B. The patients motivation is to assume the role of a sick person. […] C. There are no external motives that explain the behavior. […] Includes intentionally fabricating physical or psychological symptoms without having any actual illnesses. Motivation must lie in assuming the sick role and not for personal gain as in malingering. […] Patients may do things to make it look like they are ill and need medical attention such as; contaminating urine sample, ingesting harmful substances like bacteria to invoke some sort of physical proof that they need care, taking hallucinogens, purposefully infecting minor cuts or scrapes to increase the severity and increase the medical attention administered.

• #1 Factitious Disorders (300.19) | Abnormal Psychology

  https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/factitious-disorders-300-19/

  Patients may have long medical histories with many hospital admissions. Their records are usually vague and inconsistent. […] The patient may have an unusual knowledge of the supposed disease as if they just had definitions to go off of without any true experience. […] They could be employed in a medical setting. […] Their hospital visits are usually around hospitals and weekends when the experienced staff is not working so they will have a less likely chance of being caught but still get the same treatment. […] The person will probably receive few hospital visits even if they claim to be an important figure. […] The patient may be unusually comfortable with invasive procedures, uncomfortable surgeries, or a drastic diagnosis. […] Their hospital behavior could be classified as controlling, hostile, attention-seeking, or disruptive.

• #1 Factitious disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/factitious-disorder/diagnosis-treatment/drc-20356034

  Diagnosing factitious disorder is often very hard. […] Treatment of factitious disorder is often hard, and there are no standard therapies. […] Either way, the healthcare professionals try to steer people with factitious disorder toward care with a mental health professional. […] Treatment often focuses on managing the condition and making people better able to function, rather than trying to cure it. […] Treatment may not be accepted or may not help, especially for people with severe factitious disorder. […] Along with professional treatment, these tips may help people who have factitious disorder: Stay with your treatment plan. […] Have a medical gatekeeper. […] People with factitious disorder are likely to first get care for this condition when healthcare professionals raise concerns that mental health issues may play a part in an illness.

• #1 Munchausen Syndrome (Factitious disorder)

  https://www.webmd.com/mental-health/munchausen-syndrome

  Munchausen syndrome is a factitious disorder, a mental health disorder in which a person repeatedly and deliberately acts as if they have a physical or mental illness when they are not really sick. […] Diagnosing Munchausen syndrome is very difficult due to the dishonesty involved. Doctors must rule out any possible physical and mental illnesses before a diagnosis of Munchausen syndrome can be considered. […] Although a person with Munchausen syndrome actively seeks treatment for the various disorders they invent, the person often is unwilling to admit to and seek treatment for the syndrome itself. This makes treating people with Munchausen syndrome very challenging and the outlook for recovery poor. […] As with other factitious disorders, the primary treatment for Munchausen syndrome is psychotherapy or talk therapy (a type of counseling). Treatment usually focuses on changing the thinking and behavior of the individual (cognitive behavioral therapy). Family therapy may also help teach family members not to reward or support the behavior of the person with the disorder. […] There is no known way to prevent Munchausen syndrome, but treating it as soon as you notice symptoms may help. Munchausen syndrome is difficult to treat, so a health care provider will most likely help manage the condition rather than trying to cure it.

• #1 How to Deal With Someone With Munchausen Syndrome

  https://balancerehabclinic.com/factitious-disorder/

  Factitious disorder is a complex mental illness in which a person deceives people by pretending to be unwell, getting sick deliberately, or injuring themselves. […] Its difficult to diagnose and manage factitious disorders. However, medical and mental health assistance is essential for averting major injuries and even death from self-harm, which is a common adverse outcome of this disorder. […] The diagnosis is made on objectively recognizing made-up symptoms rather than the persons aim or motivation. […] When a doctor suspects factitious disorder, its because: The medical history of the individual does not make sense. […] The individual is adamant about not collecting information from past health records, other healthcare professionals, or close relatives. […] The individual is caught red-handed for lying or injuring someone.

• #1 Factitious Disorder vs Malingering: Key Differences and Signs

  https://goodhealthpsych.com/blog/factitious-disorder-vs-malingering/

  The motivation behind the behavior for factitious disorder vs. malingering is the primary difference. As mentioned, someone with malingering is motivated by an intentional and personal gain whereas someone with factitious doesn’t have any clear motive although they might be trying to get sympathy or attention. […] The most common signs of factitious disorder are consistent patterns of seeking medical attention with inconsistent or extreme and unrelated symptoms. The symptoms are usually uncontrollable and very vague, and the symptoms will change once treatment begins. […] Individuals who have signs of factitious disorder will possess extensive knowledge of medical diseases, terms, and memorized textbook descriptions. […] Those same individuals will also have a willingness to undergo very invasive medical procedures, including things that are risky or painful, operations, and more.

• #1 Disorders – Somatic Symptom Disorder and Factitious Disorder

  https://leveluprn.com/blogs/psychiatric-mental-health/35-disorders-somatic-symptom-disorder-factitious?srsltid=AfmBOoqvQMtXPmgWR0SpZfA9VFDCroAlFJP4tLtmuh-msjBnbsUO24IE

  Moving on to factitious disorder, which is also known as Munchausen syndrome. With this disorder, the individual exaggerates, fakes, or induces physical symptoms or psychological symptoms in order to get attention. […] Diagnosis of factitious disorder is extremely difficult, so this disorder would be diagnosed when there is evidence of deceptive behavior. For example, if a patient is coming in with complaints of chronic diarrhea but a stool sample is positive for laxatives, then that would be evidence of deceptive behavior. Treatment of factitious disorder includes talk therapy as well as medications to treat psychiatric comorbidities.

• #1 Factitious Disorder | Concise Medical Knowledge

  https://www.lecturio.com/concepts/factitious-disorders/

  Management of factitious disorders should be focused on 3 principles: Reduce risk of morbidity and mortality. Address underlying psychiatric illness. Beware of legal/ethical implications. […] Confront the patient in a nonthreatening manner: Videographic evidence of devious behavior may assist in facilitating conversation, as patients may deny their behavior. Patients should be referred for psychotherapy. […] Caution must be exercised during confrontation, as therapeutic rapport may be lost and the patient may seek another provider. […] Avoid unnecessary procedures. […] Factitious disorder imposed on another person warrants a referral to child protective services or appropriate judicial department! […] Prognosis is poor and treatment should be focused on managing rather than curing the disorder.

• #1

  https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2024/07000/hidden_harm__factitious_disorder_imposed_on.3.aspx

  Nurses are often the first to observe maltreatment and identify potential symptoms of this disorder. Proper vigilance, assessment, and mitigation strategies are essential to prioritize the well-being of dependents. […] Despite these challenges, nurses play a critical role in the detection of and intervention for FDIA to mitigate the risks of physical and mental harm to the individual who has been abused. This article will provide information about FDIA, including characteristics and risk factors for developing the disorder, patient characteristics, signs and symptoms of FDIA, psychological and emotional impact, diagnostic criteria, interventions, and nursing implications. […] Nurses must thoroughly understand the characteristics and management of and care strategies for this disorder. […] Nursing implications for FDIA require a high level of attention and a thorough understanding of this complex psychiatric disorder. Nurses play a critical role in the early detection of and intervention for FDIA cases, often as the first to observe discrepancies between reported symptoms and clinical findings.

• #1 Factitious Disorder Imposed on Another (FDIA) – Nursing CE Central

  https://nursingcecentral.com/lessons/factitious-disorder-imposed-on-another-fdia/

  As nurses strive to become advocates for their patients, we must collect data in unique, puzzling situations. Diagnosing Factitious Disorder Imposed on Another (FDIA) is not a simple task and not within the scope of nursing practice. However, nurses have a unique responsibility to gather data, critically question inconsistent results, apply knowledge on this mental disorder, and advocate for their patients. […] Treatments and resources are available for these patients and those impacted by FDIA. […] Nurses should beware of warning signs and feel confident in reporting and safety measures. […] The immediate approach is to remove the victim from harm and remove the opportunity to continue the deception. […] It is important to remember that although bizarre behavior may be exhibited by a parent or caregiver, the safety of the pediatric patient is a priority. Care for pediatric patients must be holistic. […] Early detection and intervention are important for achieving better outcomes.

• #1 21.3 Factitious Disorder – Psychiatric-Mental Health Nursing | OpenStax

  https://openstax.org/books/psychiatric-mental-health/pages/21-3-factitious-disorder

  By the end of this section, you will be able to: […] Plan nursing and collaborative care for clients seeking treatment for factitious disorder. […] Building trust and rapport with the client is a crucial first step in the care of the client with factitious disorder, even though the clients behaviors may seem deceptive. Nurses should create a nonjudgmental and empathetic environment where clients feel safe discussing their concerns, while still setting clear boundaries and limits with the client. […] The goal of treatment is to replace maladaptive attention-seeking behavior with positive behaviors. Treatment usually involves long-term psychotherapy. Nurses can offer stress coping skills as alternatives to expression of illness symptoms. […] Begin by gathering a thorough medical history, including past hospitalizations, surgeries, and treatments. Pay attention to inconsistencies or discrepancies in their reported medical history and observe any discrepancies between reported symptoms and medical findings.

• #1 Experience treating patients with Munchausen Syndrome – General Nursing Support

  https://allnurses.com/experience-treating-patients-munchausen-syndrome-t732765/

  I just listened to this podcast episode about an individual living with Munchausen’s and she talks about in her Podcast how it was a nurse that saved her life because she finally felt comfortable enough opening up to the nurse about her condition. It got me thinking as a new nurse, how do you build rapport with a patient who has suspected Munchausen’s? I suspect I treated one a few months ago and I just remember the patient being very upset and hard to please. […] It’s hard for a medical nurse to address the problem by building a rapport, because the attention you give as a medical nurse in the acute environment reinforces the behavior. […] The best way to handle it in my opinion is to give minimal attention for medical self injury while *at the same time* give maximum attention for healthy behavior, and if none is present spend a lot of attention encouraging healthy behavior and rewarding the patient with attention when he or she identifies and/or practices healthy coping skills.

• #1 Factitious disorder | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/factitious-disorder

  Factitious disorder is a rare condition that can be hard to diagnose and treat. Help from medical and mental health professionals is critical to prevent serious injury and even death when people with factitious disorder hurt themselves. […] Treatment of factitious disorder is often hard, and there are no standard therapies. Because people with factitious disorder want to be in the sick role, they often aren’t willing to seek or accept treatment for the condition. But if approached in a way that doesn’t judge, people with factitious disorder may agree to have a mental health professional assess and treat them. […] Either way, the healthcare professionals try to steer people with factitious disorder toward care with a mental health professional. And both healthcare professionals and loved ones can reinforce healthy, productive behaviors and not give too much attention to symptoms.

• #1 21.3 Factitious Disorder – Psychiatric-Mental Health Nursing | OpenStax

  https://openstax.org/books/psychiatric-mental-health/pages/21-3-factitious-disorder

  Collaborate with other health-care professionals, such as psychiatrists or social workers, to gather additional information and perspectives. […] According to Weber (2023), a multidisciplinary approach is most effective when treating factitious disorder. Nurses should engage in collaboration with psychiatrists and primary care providers, social service professionals, and therapists. […] It is crucial to address any underlying psychiatric conditions, such as personality disorders or trauma-related disorders, that may contribute to the development or maintenance of factitious disorder. […] Providing a supportive and nonjudgmental environment is also critical when treating factitious disorder. Nurses can play a key role in building trust, establishing therapeutic relationships, and demonstrating empathy toward the client.

• #1 Factitious Disorder Imposed on Self (Munchausen’s Syndrome) Treatment & Management: Approach Considerations, Initial Treatment Measures, General Medical Care

  https://emedicine.medscape.com/article/291304-treatment

  Healthcare providers should work as a team, together with nursing, social work, and legal personnel. The patient should be gently confronted with the teams suspicions in a supportive manner that focuses on the patients psychological distress as the source of illness. Psychiatric treatment should be offered to the patient. […] Patients with factitious disorder must be evaluated fully and assessed for comorbid psychiatric diagnoses. Treating any other disorders that are present may lead to improvement or resolution of the factitious behavior. A small percentage of patients with factitious disorder will consent to psychiatric treatment. If such consent is obtained, transfer from the medical floor to an inpatient psychiatric department is indicated. […] Pharmacotherapy must be monitored carefully to prevent patients from perpetuating self-destructive behavior. Medications to treat the symptoms of personality disorders, such as selective serotonin reuptake inhibitors (SSRIs) to possibly reduce impulsivity, can be of benefit.

• #1 Factitious Disorders: What Are They, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/9832-an-overview-of-factitious-disorders

  Factitious disorders happen when you create symptoms of an illness to receive care for yourself or someone else. These mental health conditions are harmful and can be life-threatening. Many people deny having a factitious disorder, which can make diagnosing and treating it difficult. Help is available. […] The first goal of treatment for factitious disorders is to modify harmful behaviors and reduce the misuse or overuse of medical resources. Once you meet these goals, your care team will focus on addressing any underlying causes of your behavior and help you find solutions to meet your needs. […] The main focus of factitious disorders management is decreasing harm. Healthcare providers might work together to make sure you dont undergo unnecessary medical testing or treatment. Many medical tests and treatments can cause harmful effects (like side effects or organ damage from antibiotics you dont need).

• #1 Factitious disorder: causes, symptoms, and treatments – The Diamond Rehab Thailand

  https://diamondrehabthailand.com/what-is-factitious-disorder/

  Available treatments for factitious disorder are intended to change a persons behavior and decrease misuse of medical sources. Treatments available for factitious disorder are listed below. Psychotherapy: The main treatment for factitious disorder; focuses on changing the thinking and behavior of a person with this disorder. […] Family therapy: Teaches family members to avoid rewarding or reinforcing the behavior of a person with factitious disorder. […] Medications: Although there are no specific medications for factitious disorder, a healthcare provider prescribes anti-anxiety medications or antidepressants to treat related disorders. […] Hospitalization: This approach is commonly employed in severe cases and involves temporary stay in a psychiatric hospital. […] Primary care doctor: Having one doctor to oversee medical care to eliminate or decrease visits to multiple healthcare professionals.

• #1 Factitious Disorders: What Are They, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/9832-an-overview-of-factitious-disorders

  Sometimes, healthcare providers may try to prevent you from harming yourself (like reducing your access to direct lines into your blood vessels to decrease the risk of self-induced infection). […] A provider may also treat factitious disorders by addressing any underlying psychological motivations that cause deceptive behaviors. Everyones treatment plan is unique. […] The most common treatment for factitious disorder is psychotherapy (a type of counseling). Youll likely focus on changing your thinking and behaviors (cognitive-behavioral therapy) and learn healthier coping mechanisms. Family therapy also may teach your loved ones not to reward or reinforce certain behaviors. […] There arent medications available to treat this condition. However, you may need medications to treat associated conditions, such as depression or anxiety.

• #1 21.3 Factitious Disorder – Psychiatric-Mental Health Nursing | OpenStax

  https://openstax.org/books/psychiatric-mental-health/pages/21-3-factitious-disorder

  Setting clear boundaries and limits is essential in managing factitious disorder. Health-care providers must establish guidelines for appropriate care and interventions, such as planning with the client which topics to be discussed during therapy sessions or nursing interactions. […] Nursing care for factitious disorder imposed on another is a highly complex and challenging situation. […] Recognize the signs: Nurses should be vigilant in recognizing the signs and symptoms of factitious disorder imposed on another. […] Protect the victim: The primary focus in these cases is to ensure the safety and well-being of the victim. […] Collaborate with the health-care team: Work closely with the health-care team, including physicians and advanced practice providers, child protection specialists, social workers, and psychologists, to develop a comprehensive approach to care. […] Focus on the victims needs: Provide appropriate medical care and support for the victims genuine health needs while avoiding unnecessary interventions related to fabricated or induced symptoms.

• #1 Factitious Disorder: Navigating the Challenges of Deceptive Illnesses | CARLAT PUBLISHING

  https://www.thecarlatreport.com/articles/4978-factitious-disorder-navigating-the-challenges-of-deceptive-illnesses

  Managing FD in patients like Emily requires a balance of empathy and firmness. Here are the steps for addressing FD: Supportive confrontation. A supportive confrontation approach, where you discuss evidence of fabricated illness openly but nonjudgmentally with the patient, can be effective. […] You and the care team meet with Emily to discuss her diagnosis. You tell her, „Emily, we’ve taken a close look at your medical history and the results from your tests. We’ve noticed some inconsistencies that don’t quite match with any known medical conditions. It’s possible that stress or other psychological factors might be contributing to your symptoms. Our aim is to support you and help you feel better.” […] FD is a complex, often under-diagnosed condition that requires careful, empathetic handling. Patients often go to great lengths to induce or fabricate medical symptoms, putting themselves at risk of genuine harm. Engage patients in frank but nonjudgmental dialogue to best manage this condition.

• #1 Factitious Disorders in Everyday Clinical Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7505250/

  The pathological feigning of disease can be seen in all medical disciplines. It is associated with variegated symptom presentations, self-inflicted injuries, forced but unnecessary interventions, unusual and protracted recoveries, and frequent changes of treating physician. […] The suspicion that a patients problem may be, at least in part, factitious is subject to a strong taboo and generally rests on supportive rather than conclusive evidence. The danger of misdiagnosis and inappropriate treatment is high. […] Through the early recognition and assessment of clues and warning signs, the clinician will be able to judge whether a factitious disorder should be considered as a differential diagnosis, as a comorbid disturbance, or as the suspected main diagnosis. A stepwise, supportive confrontation of the patient with the facts, in which continued therapeutic contact is offered and no proofs or confessions are demanded, can help the patient set aside the sick role in favor of more functional objectives, while still saving face.

• #1 Factitious Disorders in Everyday Clinical Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7505250/

  A supportive confrontation can also be used to openly explain the opportunities of psychotherapy. Some patients take this offereven if initially only in order to improve their abilities to relax or cope with stress or pain. […] The physicians first and foremost duty is to protect affected individuals from themselves, as well as from unnecessary procedures and treatments.

• #1 Factitious Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557547/

  Factitious disorder is a condition in which a patient intentionally falsifies medical or psychiatric symptoms, which can be self-induced or fabricated. This activity describes the evaluation and management of factitious disorder and reviews the role of the interprofessional team in improving care for patients with this condition. […] Studies show that the only currently available effective treatment for factitious disorder is psychotherapy. Based on available research, medication does not significantly improve symptoms of factitious disorder. However, patients with factitious disorder often have comorbid psychiatric conditions such as depression. In these patients, it is important to treat the comorbid symptoms appropriately, as this may indirectly improve factitious behavior. […] A comprehensive history and physical exam can prevent the patient from undergoing unnecessary workups and risky procedures. Thorough documentation of all findings and diagnoses in patients with factitious disorders is important for future reference of providers caring for these patients. Patients with factitious disorder often deny behavior when confronted, and many are lost to follow-up. However, attempts should be made to initiate proper treatment and provide appropriate care for this population.

• #1 Open Notes and Closed-Loop Communication: A Case of Factitious Disorder in the Age of Transparent Medical Records

  https://scholars.direct/Articles/psychiatry/jptr-3-011.php?jid=psychiatry

  We will highlight the effects of Open Notes on team communication, treatment planning, and clinical outcome in this patient with factitious disorder, as well as potential strategies to address these unique dynamics. […] In light of her refractory symptoms and extensive yet unremarkable work-up, numerous teams were already considering the diagnosis of LPHS. […] While a few concerns regarding factitious or malingered symptoms were documented in hidden notes citing „preventing harm to the patient,” the majority were omitted from the patient chart in the setting of uncertainty about the merit of single observations and what would happen if the patient read notes documenting these concerns. […] Ultimately, with her family’s encouragement and firm boundaries, the patient was discharged 54 days after her initial presentation.

• #1 Factitious Disorder – PsychDB

  https://www.psychdb.com/somatic/dsm-5/factitious

  Factitious disorder usually has first onset in early adulthood, often following a hospitalization for medical or psychiatric reasons. […] The overall prognosis is generally poor when confronted, the majority of individuals will deny their behaviours, and very few will seek treatment. […] The primary treatment for factitious disorder is psychotherapy, including psychoanalytic or psychodynamic therapy, cognitive behavioural therapy and family therapy. […] In factious disorder imposed on another, treatment considerations are similar to those in factitious disorder, with the added concern about the safety of the potential victim. […] Management often requires a team that includes social workers, foster care organizations, and law enforcement in addition to the healthcare providers.

• #1 Factitious Disorder Imposed on Self – Mental Health Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/mental-health-disorders/somatic-symptom-and-related-disorders/factitious-disorder-imposed-on-self

  Factitious disorder is pretending to have or producing physical or psychological symptoms for no apparent external reason (not for a clear benefit, such as missing work or school). […] There are no clearly effective treatments, but psychotherapy may help. […] An important part of treatment is for doctors to avoid doing unnecessary tests and treatments. […] Psychotherapy, particularly cognitive-behavioral therapy, may help. It focuses on changing the thinking and behavior of the person. It may also help the person identify and work on underlying issues that are causing the disorder.

• #1 Factitious Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557547/

  Factitious disorder is an inherently secretive disorder, and thus, many patients go undiagnosed and untreated. These patients may present to nearly any specialty. Many physicians and other healthcare providers are unfamiliar with managing these patients and strategies for providing care. Healthcare providers must familiarize themselves with tools for identifying these patients to prevent unnecessary workups and risky procedures to initiate appropriate treatment.

• #1 Experience treating patients with Munchausen Syndrome – General Nursing Support

  https://allnurses.com/experience-treating-patients-munchausen-syndrome-t732765/

  How can a medical nurse address factitious disorder while caring for a patient with self-inflicted illness? I feel like there are some answers. […] It might be appropriate to be gently confrontational. Eg… „It seems that fecal matter was put into your line on purpose.” […] Or more firmly confrontational […] „What did you hope would happen when you put fecal matter in your line?” […] I did have a patient when I worked in psych with extreme Factitious disorder/Munchausens. The patient was very time-consuming and the disorder was frustrating to deal with. They were a wonderful person, but absolutely exhausting. […] I have met one during my entire time in healthcare. It was bizarre and also involved fecal matter ? But that is literally the one and only case I have seen.

• #1 CEConnection for Nursing : Hidden Harm: Factitious Disorder Imposed on Another

  https://nursing.ceconnection.com/public/modules/18898

  Describe FDIA and its associated characteristics and risk factors. […] Identify nursing interventions for individuals affected by FDIA. […] By the conclusion of this activity, a majority of the participants will demonstrate knowledge of factitious disorder imposed on another (FDIA) by achieving a passing score on the posttest.

• #1 Factitious Disorder – Bridges to Recovery

  https://www.bridgestorecovery.com/factitious-disorder/

  Treatment for factitious disorder is challenging, largely because the patient often cannot recognize that there is anything wrong with their behaviors or thought patterns. The best outcomes from treatment occur when the patient realizes there is a problem. To get to this point is difficult or even sometimes impossible. An approach that is supportive rather than critical is important. Unsupportive or judgmental confrontation can cause the patient to become angry and defensive and to refuse any mental health treatment. […] The role of the physician is to make sure the patient is getting necessary medical treatments for actual physical complaints or self-injuries. The mental health professionals provide therapy and, if necessary, medications for depression or anxiety. […] Individual therapy and family therapy can be useful. The latter helps educate the family while also guiding them to learn how to support their loved one in a productive way. Individual therapy can help the patient learn to recognize their flawed thinking, make positive changes, and manage stress with healthy coping strategies. […] The prognosis for factitious disorder relies strongly on the ability of the patient to accept treatment. If they do, the outlook is positive and ongoing care can lead to a resolution of symptoms.

• #1 Factitious Disorder: Signs, Symptoms & Causes | All You Should Know

  https://www.therecoveryvillage.com/mental-health/factitious-disorder/

  Factitious disorder is a mental health condition where person purposely fabricates an illness, impairment or injury to receive attention and medical care. […] Treatment for factitious disorder is challenging for many physicians who must carefully rule out other possibilities of a rare sickness or other disorders such as malingering or conversion disorder. […] A multidisciplinary approach is necessary, including adding a mental health expert to the team to aid in treatment. […] For treatment to be most successful, the person with factitious disorder must agree to work with a health care team and the outlined factitious disorder treatment plan. […] Some common forms of treatment or therapy for factitious disorder can include: Psychotherapy, Cognitive-behavioral therapy, Pharmacotherapy, Treatment of co-occurring conditions, Individual therapy, Patient education. […] The earlier that factitious disorder is identified and treated, the better the prognosis and outlook for the individual.

• #1 Factitious Disorder Imposed on Self (Munchausen’s Syndrome) Treatment & Management: Approach Considerations, Initial Treatment Measures, General Medical Care

  https://emedicine.medscape.com/article/291304-treatment

  Psychotherapy should focus on establishing and maintaining a relationship with the patient. Supportive psychotherapy may help contain the symptoms of factitious disorder. However, little information is available on which type of psychotherapy is most effective in helping patients overcome factitious disorder. […] Involuntary hospitalization into a psychiatric hospital is indicated when the patient meets statutory criteria for admission. Generally, this requires the patient to be at imminent risk of harm to self or others. […] Close psychiatric follow-up care and monitoring in the outpatient setting are indicated to prevent relapse. Close medical follow-up care may also be necessary, depending on the condition.

• #1 Factitious Disorder: Symptoms, Causes & Treatment

  https://www.jagrutirehab.org/disorder/factitious-disorder.html

  It requires continuous monitoring and follow-up treatment to ensure progression without relapse. Factitious disorder treatment is very slow and a gradual process requiring patience and commitment from the patient and the health care team as well. […] At Jagruti Rehab, we offer comprehensive care for those diagnosed with Factitious Disorder, with the focus on the production of treatment plans with warmth and sensitivity. Evaluations for our patients procure their medical and psychological history concerning underlying triggers and co-existing conditions. Evidence-based therapies are designed according to individualized patterns, such as Cognitive Behavioral Therapy and Dialectical Behavior Therapy, to alleviate emotional distress while helping one replace unhealthy coping strategies with healthy ones. We work with our medical patients to establish an accurate diagnosis for those with supposed imaginary symptoms and monitor the person for a medical problem. Our holistic approach incorporates techniques to help with stress management-mindfulness, yoga, and art therapy–to promote emotional health and avoid relapses.

• #1 Factitious Disorder : Know the Causes, Symptoms, & Treatment

  https://medrechospital.com/atozdetail/factitious-disorder

  Both talk therapy (psychotherapy) and behavior therapy can aid in stress management and coping mechanism development. If at all feasible, family counseling may also be recommended. It is also possible to treat depression and other mental health issues. […] For safety and therapy, it may be necessary for extreme circumstances to spend a brief period of time in a mental institution. […] These suggestions may aid those with factitious conditions in addition to medical care: Attend treatment sessions and take prescription drugs as prescribed. Speak openly with your therapist or primary care physician if you have the desire to hurt yourself or make yourself sick in order to find healthier coping mechanisms. […] Have your medical treatment managed by a dependable primary care doctor rather than seeing several different doctors, specialists, and surgeons.

• #1 Effective Factitious Disorder Treatment Relies on Compassionate Care – Bridges to Recovery

  https://www.bridgestorecovery.com/blog/effective-factitious-disorder-treatment-relies-on-compassionate-care/

  Effective Factitious Disorder Treatment Relies on Compassionate Care […] If you suspect that your loved one is struggling with factitious disorder, you may feel confused about why someone would pretend to be sick or even make themselves sick. However, the logic of factitious disorder tells them that illness is a way to get the love, care, and attention they crave. By recognizing your loved one’s symptoms and helping them connect to specialized factitious disorder treatment, you can help them truly regain their health and learn how to meet their needs in healthy ways. […] Healing from this troubling condition requires dedicated factitious disorder treatment designed with the unique needs of these clients in mind. […] The treatment process must begin with a thorough psychological assessment in order to correctly identify the presence of a factitious disorder. Input from family, friends, and outside treatment providers can be invaluable during this process, as people with factitious disorder of the self may not realize or admit to the extent of their illness. Additionally, many people with this condition struggle with comorbid psychiatric conditions, such as depression, trauma-based disorders, or personality disorders, which will need to be treated simultaneously in order to create true recovery.

• #2 Psychiatry.org – What is Somatic Symptom Disorder?

  https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder

  Factitious disorder involves people producing or faking physical or mental illness when they are not actually ill. Some people may intentionally make a minor illness worse. A person with factitious disorder may also create an illness or injury in another person (factitious disorder imposed on another), such as faking the symptoms of a child in their care. The benefit to the person is to occupy the sick role and receive the care accompanying that role. If a person creates an illness or feigns illness in order to obtain a material benefit such as getting compensation or avoiding work, legal situations, or important responsibilities, this is malingering, which is not a psychiatric diagnosis.

• #2 Factitious Disorder vs Malingering: Key Differences and Signs

  https://goodhealthpsych.com/blog/factitious-disorder-vs-malingering/

  The motivation behind the behavior for factitious disorder vs. malingering is the primary difference. As mentioned, someone with malingering is motivated by an intentional and personal gain whereas someone with factitious doesn’t have any clear motive although they might be trying to get sympathy or attention. […] The most common signs of factitious disorder are consistent patterns of seeking medical attention with inconsistent or extreme and unrelated symptoms. The symptoms are usually uncontrollable and very vague, and the symptoms will change once treatment begins. […] Individuals who have signs of factitious disorder will possess extensive knowledge of medical diseases, terms, and memorized textbook descriptions. […] Those same individuals will also have a willingness to undergo very invasive medical procedures, including things that are risky or painful, operations, and more.

• #2 Factitious Disorder vs Malingering: Key Differences and Signs

  https://goodhealthpsych.com/blog/factitious-disorder-vs-malingering/

  Someone who has a factitious disorder might manipulate their symptoms or test results in order to continually receive attention. This can be something as severe as doctoring a test in a hospital, intentionally causing pain or problems in order to increase the likelihood of a diagnosis, and self-harm. […] It is imperative that healthcare professionals learn to spot the difference between factitious disorder and malingering. […] The first way to do this is to keep comprehensive patient histories. The more records that are kept, the easier it will be to find patterns of things like unrelated symptoms or unexplained relapses, symptoms that come back long after treatment has purportedly cured them, or an unnecessarily high number of visits to a hospital. […] Keeping these histories can help other Healthcare professionals spot the signs as well particularly when there is collaboration across multiple disciplines. This type of collaboration is essential as individuals with both conditions are likely to exaggerate symptoms with inconsistency in their statements and collaboration can reveal those inconsistencies.

• #2 Factitious Disorder Treatment – Good Health Psych

  https://goodhealthpsych.com/disorders/factitious-disorder-treatment/

  After this evaluation, a tailored treatment plan is developed, which may include individual therapy, group therapy, and possibly family therapy sessions. […] The goal is to help the individual recognize their harmful behaviors, understand the underlying triggers, and develop healthier coping mechanisms. […] The cornerstone of treatment involves Cognitive Behavioral Therapy (CBT), which helps identify and alter the maladaptive thought patterns driving the deceptive behaviors. […] Group therapy provides a supportive environment to share experiences and learn from others facing similar struggles. […] Family therapy is also beneficial, as it can help improve strained family dynamics and encourage supportive behaviors. […] Over time, through consistent engagement in these therapeutic activities, individuals can expect to see changes.

• #2 Munchausen Syndrome (Factitious disorder)

  https://www.webmd.com/mental-health/munchausen-syndrome

  Munchausen syndrome is a factitious disorder, a mental health disorder in which a person repeatedly and deliberately acts as if they have a physical or mental illness when they are not really sick. […] Diagnosing Munchausen syndrome is very difficult due to the dishonesty involved. Doctors must rule out any possible physical and mental illnesses before a diagnosis of Munchausen syndrome can be considered. […] Although a person with Munchausen syndrome actively seeks treatment for the various disorders they invent, the person often is unwilling to admit to and seek treatment for the syndrome itself. This makes treating people with Munchausen syndrome very challenging and the outlook for recovery poor. […] As with other factitious disorders, the primary treatment for Munchausen syndrome is psychotherapy or talk therapy (a type of counseling). Treatment usually focuses on changing the thinking and behavior of the individual (cognitive behavioral therapy). Family therapy may also help teach family members not to reward or support the behavior of the person with the disorder. […] There is no known way to prevent Munchausen syndrome, but treating it as soon as you notice symptoms may help. Munchausen syndrome is difficult to treat, so a health care provider will most likely help manage the condition rather than trying to cure it.

• #2 Mental Health: Factitious Disorders

  https://www.webmd.com/mental-health/factitious-disorders

  The primary treatment for factitious disorders is psychotherapy (a type of counseling). […] There are no medications to treat factitious disorders themselves. […] People with factitious disorders are at risk for health problems (or even death) associated with hurting themselves or otherwise causing symptoms. […] Because many people with factitious disorders deny they are faking symptoms and will not seek or follow treatment, recovery is dependent on a doctor or loved one identifying or suspecting the condition in the person and encouraging them to receive proper medical care for their disorder and stick with it.

• #2 Factitious disorder | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/factitious-disorder

  Treatment often focuses on managing the condition and making people better able to function, rather than trying to cure it. Treatment generally includes: Having a primary healthcare professional. Using one healthcare professional to oversee medical care can help manage needed care and the treatment plan. This can reduce or stop visits to many healthcare professionals that aren’t needed. […] If factitious disorder symptoms are severe, a short stay in a mental health hospital may be needed for safety and to create a treatment plan.

• #2 Experience treating patients with Munchausen Syndrome – General Nursing Support

  https://allnurses.com/experience-treating-patients-munchausen-syndrome-t732765/

  I just listened to this podcast episode about an individual living with Munchausen’s and she talks about in her Podcast how it was a nurse that saved her life because she finally felt comfortable enough opening up to the nurse about her condition. It got me thinking as a new nurse, how do you build rapport with a patient who has suspected Munchausen’s? I suspect I treated one a few months ago and I just remember the patient being very upset and hard to please. […] It’s hard for a medical nurse to address the problem by building a rapport, because the attention you give as a medical nurse in the acute environment reinforces the behavior. […] The best way to handle it in my opinion is to give minimal attention for medical self injury while *at the same time* give maximum attention for healthy behavior, and if none is present spend a lot of attention encouraging healthy behavior and rewarding the patient with attention when he or she identifies and/or practices healthy coping skills.

• #2 Open Notes and Closed-Loop Communication: A Case of Factitious Disorder in the Age of Transparent Medical Records

  https://scholars.direct/Articles/psychiatry/jptr-3-011.php?jid=psychiatry

  This allowed for the clinicians to hide their mounting concerns in a separate note, while also ensuring clear documentation for gathering evidence towards a differential diagnosis. […] Given many clinicians have come to rely on the electronic health record as the main source of communication between providers, omitting information from documentation may add to diagnostic uncertainty in situations of suspected factitious disorder. […] It may be helpful to consider ways in which the Open Notes Rule can serve as a tool for therapeutic intervention, specifically with respect to factitious disorder. […] Developing a strategy to approach note-writing in factitious disorder may provide clinicians with a useful clinical tool to position themselves as patient allies and improve adherence to treatment plans for better outcomes. […] Overall, optimizing effective communication between members of a multi-disciplinary team may involve face-to-face communication for review of complicated medical and psychiatric diagnoses.

• #2 Factitious Disorder : Know the Causes, Symptoms, & Treatment

  https://medrechospital.com/atozdetail/factitious-disorder

  Every time you damage yourself or undergo an unnecessary dangerous test or procedure, remind yourself that you may suffer permanent harm or even death. […] Avoid the impulse to change your doctor or relocate. a place where the medical staff is unaware of your history. You may defeat these strong cravings with the assistance of your therapist. […] Many persons who suffer from the factitious disorder are socially and romantically isolated. Look for someone you can trust, with whom you can have fun and with whom you can provide assistance.

• #2

  https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2024/07000/hidden_harm__factitious_disorder_imposed_on.3.aspx

  Nurses are often the first to observe maltreatment and identify potential symptoms of this disorder. Proper vigilance, assessment, and mitigation strategies are essential to prioritize the well-being of dependents. […] Despite these challenges, nurses play a critical role in the detection of and intervention for FDIA to mitigate the risks of physical and mental harm to the individual who has been abused. This article will provide information about FDIA, including characteristics and risk factors for developing the disorder, patient characteristics, signs and symptoms of FDIA, psychological and emotional impact, diagnostic criteria, interventions, and nursing implications. […] Nurses must thoroughly understand the characteristics and management of and care strategies for this disorder. […] Nursing implications for FDIA require a high level of attention and a thorough understanding of this complex psychiatric disorder. Nurses play a critical role in the early detection of and intervention for FDIA cases, often as the first to observe discrepancies between reported symptoms and clinical findings.

• #2 Effective Factitious Disorder Treatment Relies on Compassionate Care – Bridges to Recovery

  https://www.bridgestorecovery.com/blog/effective-factitious-disorder-treatment-relies-on-compassionate-care/

  Once a diagnosis has been made, comprehensive factitious disorder treatment should begin. Often, people with this condition readily accept treatment and are willing to participate as assuming the role of the sick person fulfills a deep emotional need. However, it is critical that psychiatrists and therapists use psychotherapy to guide your loved one toward healing rather than allow them to linger within their illness. To do this, clinicians should lead them toward a deeper understanding of their condition in a non-judgmental way, allowing them to recognize the roots of their disorder and acknowledge their struggles without fear of humiliation. […] However, factitious disorders don’t just affect your loved one. Often, family members are intimately—and unknowingly—involved in the effects of the condition, and healing requires a transformation of the entire group. As such, the treatment program your loved one attends should include family therapy options designed to give you the support you need throughout the treatment process. […] For Catherine and Sarah, factitious disorder treatment was truly transformative. “She was finally able to meet her needs in an authentic way. She was able to feel loved and cared for simply for being herself, not because she was sick,” Sarah says.

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