Materiały źródłowe

• #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. People with factitious disorder are experts at faking many diseases and conditions. And while these people often look like they have real and even life-threatening medical conditions, they may have brought those conditions on themselves. […] Diagnosis is based on objectively identifying symptoms that are made up, rather than the person’s intent or motivation for doing so. A healthcare professional may suspect that people have factitious disorder when: Their medical history doesn’t make sense. No believable reason exists for an illness or injury. The illness doesn’t follow the usual course. There’s no clear reason why they’re not getting better, despite the right treatment. There are contradictory or inconsistent symptoms or lab test results. They don’t want to give information from previous health records, other healthcare professionals or family members. They’re caught lying or harming themselves. […] To help figure out if a person has factitious disorder, healthcare professionals: Do a detailed interview. Require past health records. Work with family members to get more information if the person being examined gives permission. Run only tests needed to look at possible physical issues.

• #1 Factitious Disorder: Symptoms, Causes, and Treatment

  https://www.healthline.com/health/factitious-disorder

  Factitious disorder is a mental health condition that involves at least one episode of manufactured or exaggerated physical or mental health symptoms. […] The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) lists two different types. […] The DSM-5 estimates about 1 percent of people receiving inpatient hospital care may meet the diagnostic criteria for factitious disorder. […] A 2014 study suggests people with this condition feel unable to stop these behaviors, even when they want to. […] Experts dont know a lot about how common factitious disorder is or what causes it, partly because it can be difficult to identify. […] Factitious disorder can stem from, and contribute to, significant emotional distress. […] If you think you might be experiencing symptoms of factitious disorder, therapy, including CBT, can help.

• #1 Factitious Disorder Imposed on Self (Munchausen Syndrome)

  https://my.clevelandclinic.org/health/diseases/9833-munchausen-syndrome-factitious-disorder-imposed-on-self

  Your healthcare provider(s) will refer to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to determine if your symptoms compare to the criteria for this condition. The DSM-5 is the standard reference book for recognized mental health conditions in the United States. […] Diagnostic criteria for factitious disorder imposed on self include: Falsifying physical or psychological signs and symptoms, inducing injury or disease; Presenting to others as ill, impaired or injured; Deceptive behavior that happens without an external reward; Another mental health condition doesnt explain the behavior well.

• #1 Factitious Disorder DSM-5 300.19 (F68.10)

  https://www.theravive.com/therapedia/factitious-disorder-dsm–5-300.19-(f68.10)

  Factitious disorder may be diagnosed as either a single episode or as recurrent episodes (two or more instances of illness falsification and/or induction of injury). […] Factitious disorder in another (formerly known as previously called Munchausen syndrome by proxy) may be broadly diagnosed using the same four criteria as above: Intentional induction or falsification of physical or psychological signs or symptoms in another person, The individual presents another individual (the victim) as ill, impaired or injured to others, The deceptive behavior persists even in the absence of external incentives or rewards, Another mental disorder does not better explain the behavior. […] As with factitious disorder, factitious disorder in another may be diagnosed as either a single episode or as recurrent episodes (two or more instances of illness falsification and/or induction of injury).

• #1 Mental Health: Factitious Disorders

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

  How Are Factitious Disorders Diagnosed? […] Diagnosing factitious disorders is very difficult because of, again, the dishonesty that is involved. Doctors must rule out other possible physical and mental illnesses before a diagnosis of factitious disorder can be considered. […] If the doctor finds no physical reason for the symptoms, or suspects that symptoms or abnormal laboratory results may be self-induced, they may refer the person to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a factitious disorder. The doctor bases their diagnosis on the exclusion of actual physical or mental illness, and their observation of the person’s attitude and behavior.

• #1 Factitious disorders – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/695

  Factitious disorders are uncommon disorders in which the patient intentionally fabricates physical or psychological symptoms primarily for the purpose of deceiving healthcare providers and/or others. […] Factitious disorder is a syndrome in which signs and/or symptoms of disease are intentionally feigned, exaggerated, or self-induced by a patient when there is no clear principal external incentive for the behaviour. […] Distinguishing factitious disorder from related conditions can be a difficult task, particularly because they can sometimes co-exist in the same patient. […] Key diagnostic factors include presence of risk factors, history of unexplained complaints or inconsistency over time, and unusual presentation relative to demographics. […] Other diagnostic factors include symptoms more exaggerated while aware of being observed, presentation for care at many different hospitals, and eyewitness evidence of the patient manipulating findings. […] 1st investigations to order include clinical history and examination. […] Investigations to consider include cultures (e.g., blood or wound), serum C-peptide, urine sulphonylureas, urine electrolytes, urine protein, and serum thyroglobulin.

• #1 Laboratory diagnosis of factitious disorders – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8042885/

  Self-induced factitious disorders are defined and distinguished from conditions they may resemble. […] Up to 5% of physician-patient encounters may be because of factitious disorders, but these are only suspected when the workup leads to contradictory findings. […] Laboratory tests are often the only definitive diagnostic method, and clinicians may not be familiar with current technologies. […] Discordant laboratory results should raise the possibility of a factitious disorder. […] Sophisticated laboratory tests that can accurately assay very small amounts of specific hormones or foreign substances in body fluids facilitate the diagnosis. […] The primary physician can now confirm an initial clinical diagnosis of factitious disorder promptly and directly rather than only by exclusion.

• #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. […] The diagnosis of factitious disorder is most often based on DSM-5 criteria: Identified deception involves falsification of psychological or physical symptoms or induction of injury or disease. […] If factitious disorder is suspected, evaluation should be geared toward providing objective evidence of deception and falsification of a medical or psychiatric condition. […] Some argue that the DSM does not recognize that deception is normal human behavior and should not be considered pathologic in all cases. […] Studies show that the only currently available effective treatment for factitious disorder is psychotherapy. […] When a diagnosis of factitious disorder is suspected, it is important to consider other likely etiologies: Malingering – the conscious feigning of symptomatology to obtain secondary gain – is 1 of the most difficult diagnoses to distinguish from factitious disorder, as motivation may be difficult to ascertain in many cases.

• #1 Factitious Disorder – PsychDB

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

  The individual presents another individual (victim) to others as ill, impaired, or injured. […] The deceptive behaviour is evident even in the absence of obvious external rewards. […] The behaviour is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder. […] Factitious disorder requires the determination that the individual is taking surreptitious actions to deliberately misrepresent, simulate, or cause signs or symptoms of illness or injury in the absence of obvious external rewards. […] In the majority of cases of factitious disorder (both imposed on self and imposed on another), individuals present with somatic symptoms and medical disease conviction, and may exaggerate symptoms. […] Presentation of signs and symptoms of illness that do not conform to an identifiable medical condition or mental disorder increases the likelihood of the presence of a factitious disorder. […] However, the diagnosis of factitious disorder does not exclude the presence of true medical condition or mental disorder, as comorbid illness often occurs in the individual along with factitious disorder.

• #1 What is Munchausen syndrome by proxy?

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

  Factitious disorder imposed on another (FDIA) is a mental illness. […] Experts describe FDIA as relatively rare but often misdiagnosed. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) report that around 1% of people in hospitals may meet criteria of a factitious disorder. […] FDIA can be hard to detect because it is relatively uncommon and because doctors can usually expect caregivers to tell the truth. […] The DSM-5 lists the following criteria for FDIA: falsifying signs or symptoms or inducing injury or disease in another person with the intention of deceiving, presenting another person as having signs and symptoms of an illness, receiving no external reward, such as financial gain, having no evidence of another condition, such as one that causes delusions. […] If a doctor suspects FDIA, they may invite a team of experts, including physicians, psychologists, and child protection workers, to evaluate different aspects of the case. […] In addition, some hospitals have used video cameras to help confirm a diagnosis.

• #1 A Systematic Review on Factitious Disorders: Psychopathology and Diagnostic Classification

  https://www.jneuropsychiatry.org/peer-review/a-systematic-review-on-factitious-disorders-psychopathology-and-diagnostic-classification-12370.html

  Factitious disorder (FD) is a psychiatric disorder in which sufferers intentionally fabricate physical or psychological symptoms in order to assume the role of the patient, without any obvious gain. […] The study showed that patients did not meet DSM-5 diagnostic criteria in the 11.3% of cases. […] Early detection of factitious disorder is very important to limit harm to patients and early management of FD may facilitate improved outcomes for patients with the disorder. […] Among the factors considered to be relevant to diagnose these disorders, the exclusion of other organic or psychiatric causes is the most represented, observed in the 91.1% of cases. […] The diagnostic criteria for DSM-5 factitious disorders were met in 88.7% of cases. The reason for the percentage of patients who do not meet the criteria (11.3%) can be found in the reclassification that these conditions had in the modern edition of the manual: some patients who first met the criteria of previous editions are now most likely included in another diagnostic category.

• #1

  https://link.springer.com/article/10.1007/s12024-020-00272-x

  The abuse of insulin in cases of factitious hypoglycemia may be comparably easy due to the possibility of detection in the laboratory, whereas a patient presenting with factitious fever may require an extensive and multidisciplinary investigation. […] The results illustrate that a laborious and sensitive consultation is needed to identify potential psychological risk factors. […] There is no reliable information about the distribution of FD patients among the medical departments to date and the results of systematic reviews of case reports and case series may indicate but do not reflect the real incidence and distribution. […] A comprehensive nationwide evaluation of the incidence of FD, which also includes the data of psychiatric hospitals and primary care physicians, appears to be of value. […] The establishment of rigid criteria may help to reliably identify patients with FD, reduce the risk of stigmatization and ensure appropriate interaction with these patients during a potential confrontation.

• #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. […] Falsification (i.e. – deliberately feigning) of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. […] The individual presents himself or herself to others as ill, impaired, or injured. […] The deceptive behaviour is evident even in the absence of obvious external rewards. […] The behaviour is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder. […] Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception.

• #1 Factitious Disorder: Detection, Diagnosis, and Forensic Implications

  https://www.psychiatrictimes.com/view/factitious-disorder-detection-diagnosis-and-forensic-implications

  The first issue is whether people with factitious disorder even qualify as patients who are entitled to treatment. […] The potential malpractice liability stemming from factitious disorder is unsettled. […] It may be very difficult to empathize with patients whose life experience has led them to the point where they feel that the best way to get their needs met is to falsify, exaggerate, aggravate, or self-induce symptoms.

• #2 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. […] The diagnosis of factitious disorder is most often based on DSM-5 criteria: Identified deception involves falsification of psychological or physical symptoms or induction of injury or disease. […] If factitious disorder is suspected, evaluation should be geared toward providing objective evidence of deception and falsification of a medical or psychiatric condition. […] Some argue that the DSM does not recognize that deception is normal human behavior and should not be considered pathologic in all cases. […] Studies show that the only currently available effective treatment for factitious disorder is psychotherapy. […] When a diagnosis of factitious disorder is suspected, it is important to consider other likely etiologies: Malingering – the conscious feigning of symptomatology to obtain secondary gain – is 1 of the most difficult diagnoses to distinguish from factitious disorder, as motivation may be difficult to ascertain in many cases.

• #2 Factitious Disorder – StatPearls – NCBI Bookshelf

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

  Patients with factitious disorders are generally considered to have a poor prognosis. […] A comprehensive history and physical exam can prevent the patient from undergoing unnecessary workups and risky procedures. […] Factitious disorder is an inherently secretive disorder, and thus, many patients go undiagnosed and untreated.

• #2 FACTITIOUS DISORDER

  https://www.psychiatrictimes.com/view/factitious-disorder

  Based on physicians’ observations and experience, researchers in Germany estimated that 1.3% of patients have factitious disorder. […] The reported 1-year prevalence of factitious disorder ranged from 0.0001% to 15%. […] The signs, symptoms, or behaviors that reportedly occur most often with factitious disorder are mechanical manipulation of the skin (57%), open lesions or injuries to the skin (54%), demonstration or statement of pain (49%), complication of wound healing (42%), chemical manipulation of the skin (30%), and demonstration or statement of other alarming symptoms (30%).

• #2 Factitious Disorder DSM-5 300.19 (F68.10)

  https://www.theravive.com/therapedia/factitious-disorder-dsm–5-300.19-(f68.10)

  Factitious disorder is a DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th ed.) diagnosis assigned to individuals who falsify illness in themselves or in another person, without any obvious gain. […] Diagnosis of factitious disorder often requires a number of investigatory steps in order to accurately identify the condition without wrongful accusation, and treatment options can be both limited and difficult to administer if the individual refuses to admit the deception. […] In order to make a diagnosis of factitious disorder, it may be necessary for a health professional to look for clues and patterns in behavior that suggest an individual is being misleading. […] There are four primary criteria for diagnosing factitious disorder. These are: Intentional induction or falsification of physical or psychological signs or symptoms, The individual presents themselves as ill, impaired or injured to others, The deceptive behavior persists even in the absence of external incentives or rewards, Another mental disorder does not better explain the behavior.

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

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

  Factitious disorder (FD), previously known as Munchausen syndrome, describes a condition where individuals fabricate or induce medical or psychiatric symptoms without clear external incentives, such as financial gain or evading legal trouble. […] FD is diagnosed based on the following DSM-5-TR criteria: 1) falsification of symptoms, 2) deceptive behavior, 3) absence of external incentives, and 4) exclusion of other mental disorders. […] Your workup will vary based on the patients presentation. For psychiatric symptoms, the diagnosis hinges on comparing the patients symptoms against known psychiatric disorders. […] The medical teams suspicions strengthen when Emilys lab results show high insulin levels but low C-peptide levels, a combination that suggests she may be injecting herself with insulin. […] Engage patients in frank but nonjudgmental dialogue to best manage this condition.

• #2 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. Many people deny having a factitious disorder, which can make diagnosing and treating it difficult. A factitious disorder is difficult to diagnose due to deceptive behaviors. A provider will make a diagnosis by learning more about you through a thorough medical history, a physical examination, laboratory testing, and imaging tests. In some cases, your provider may recommend a psychiatric or psychological evaluation. Psychiatrists and psychologists are specially trained to diagnose and treat mental health conditions.

• #2 Factitious Disorder Imposed on Self – Mental Health Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.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). […] Doctors diagnose the disorder after excluding other disorders and after discovering evidence that symptoms have been faked. […] Doctors first check for physical and mental health conditions by taking a thorough medical history, doing a thorough physical examination, and doing tests. Most of the time, the person’s description of symptoms is convincing, sometimes misleading doctors. However, doctors may suspect factitious disorder imposed on self based on the following: […] The diagnosis of factitious disorder imposed on self is made when all of the following are confirmed in a person who presents as sick, impaired, or injured: […] Doctors observe or discover evidence of exaggeration, faking, falsification, self-induced symptoms, or alterations in the medical history. […] The person has no obvious external incentives for faking or exaggerating symptoms. […] Other disorders are ruled out.

• #2 Factitious disorders – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/695

  Factitious disorders are uncommon disorders in which the patient intentionally fabricates physical or psychological symptoms primarily for the purpose of deceiving healthcare providers and/or others. […] Factitious disorder is a syndrome in which signs and/or symptoms of disease are intentionally feigned, exaggerated, or self-induced by a patient when there is no clear principal external incentive for the behaviour. […] Distinguishing factitious disorder from related conditions can be a difficult task, particularly because they can sometimes co-exist in the same patient. […] Key diagnostic factors include presence of risk factors, history of unexplained complaints or inconsistency over time, and unusual presentation relative to demographics. […] Other diagnostic factors include symptoms more exaggerated while aware of being observed, presentation for care at many different hospitals, and eyewitness evidence of the patient manipulating findings. […] 1st investigations to order include clinical history and examination. […] Investigations to consider include cultures (e.g., blood or wound), serum C-peptide, urine sulphonylureas, urine electrolytes, urine protein, and serum thyroglobulin.

• #2 Factitious Disorder Imposed on Self (Munchausen’s Syndrome) Differential Diagnoses

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

  Factitious disorder appears in the differential diagnosis for many illnesses. […] When routine examination and testing fail to confirm any of the most obvious diagnostic possibilities, factitious disorder should be excluded. […] In creating a working list of hypotheses for the diagnosis of a puzzling medical case, it is important to follow base-rate information about the frequency of each diagnostic possibility. […] Even if factitious disorder occurred only once per 10,000 patients (a frequency that is probably an underestimate), it would still be more prevalent than some of the exceptionally rare disorders that a physician might consider before entertaining the possibility that the patient is feigning illness. […] Factitious disorder and Munchausen syndrome must be distinguished from certain related types of clinical psychiatric problems.

• #2 Factitious Disorder Imposed on Self (Munchausen’s Syndrome) Differential Diagnoses

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

  In practice, diagnosis almost always requires a weighing of internal and external incentives, because the sick role itself almost always includes rewards and dispensations of various kinds. […] Typically, a malingering patient will abide only as much testing and treatment as is necessary to achieve his or her aims. In contrast, a person with factitious disorder imposed on self will actively attempt to maintain the sick role and will willingly undergo as much testing and treatment as possible. […] Other related conditions from which factitious disorder must be distinguished are somatic symptom and related disorders, particularly illness anxiety disorder. […] In its typical form, this presentation is not easily confused with factitious disorder; however, in rare instances, the patient is so strongly convinced of being gravely ill that he or she resorts to simulation or self-injury as a means of soliciting further diagnostic testing.

• #2 Factitious Disorder: Symptoms, Causes, and Treatment

  https://www.healthline.com/health/factitious-disorder

  Factitious disorder symptoms also often improve with treatment for co-occurring mental health conditions, like anxiety, depression, or a personality disorder. […] The best option generally involves offering understanding and compassion, without supporting the behavior, and encouraging them to get help from a therapist.

• #2 Factitious disorder imposed on another – Wikipedia

  https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on_another

  Use of the term „Munchausen syndrome by proxy” is controversial. In the World Health Organization’s International Statistical Classification of Diseases, 10th Revision (ICD-10), the official diagnosis is factitious disorder (301.51 in ICD-9, F68.12 in ICD-10). Within the United States, factitious disorder imposed on another (FDIA or FDIoA) was officially recognized as a disorder in 2013, while in the United Kingdom, it is known as fabricated or induced illness by carers (FII). […] In DSM-5, the diagnostic manual published by the American Psychiatric Association in 2013, this disorder is listed under 300.19 Factitious disorder. This, in turn, encompasses two types: Factitious Disorder Imposed on Self and Factitious Disorder Imposed on Another (Previously Factitious Disorder by Proxy); the diagnosis is assigned to the perpetrator; the person affected may be assigned an abuse diagnosis (e.g. child abuse). […] Both types include an optional specifier to identify if the observed behavior was a single episode or part of recurrent episodes.

• #2 What is Munchausen syndrome by proxy?

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

  Factitious disorder imposed on another (FDIA) is a mental illness. […] Experts describe FDIA as relatively rare but often misdiagnosed. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) report that around 1% of people in hospitals may meet criteria of a factitious disorder. […] FDIA can be hard to detect because it is relatively uncommon and because doctors can usually expect caregivers to tell the truth. […] The DSM-5 lists the following criteria for FDIA: falsifying signs or symptoms or inducing injury or disease in another person with the intention of deceiving, presenting another person as having signs and symptoms of an illness, receiving no external reward, such as financial gain, having no evidence of another condition, such as one that causes delusions. […] If a doctor suspects FDIA, they may invite a team of experts, including physicians, psychologists, and child protection workers, to evaluate different aspects of the case. […] In addition, some hospitals have used video cameras to help confirm a diagnosis.

• #2 Factitious Disorder Imposed on Another – Psychiatric Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/factitious-disorder-imposed-on-another

  Factitious disorder imposed on another is falsification of manifestations of an illness in another person, typically done by caregivers to someone in their care. […] In factitious disorder imposed on another, people, usually caregivers (such as a parent), intentionally produce or falsify physical or psychological symptoms or signs in a person in their care (usually a child), rather than in themselves (as in factitious disorder imposed on self). […] Factitious disorder imposed on another is typically difficult to recognize, particularly when the caregiver’s history is plausible (eg, report of a fever in an infant) and/or the victimized person is nonverbal.

• #2 Factitious Disorder: Detection, Diagnosis, and Forensic Implications

  https://www.psychiatrictimes.com/view/factitious-disorder-detection-diagnosis-and-forensic-implications

  Few phenomena in medicine are more confounding than the diagnoses involving deception: malingering, Munchausen syndrome, Munchausen by proxy (MBP), and factitious disorder. […] Factitious disorder: conscious and intentional feigning or production of symptoms, because of a psychological need to assume the sick role to obtain emotional gain. […] The evaluation involves detailed clinical examination, including extensive history (and collateral history, if the patient will consent), careful physical examination, and relevant laboratory and radiological studies. […] Testing and procedures can be repeated unnecessarily by physicians who succumb to the patient’s entreaties for additional intervention. […] Detection of medical deception must start with a high index of suspicion, perhaps triggered by inconsistencies in the medical presentation.

• #2 Factitious disorder imposed on self (Munchausen syndrome) – UpToDate

  https://www.uptodate.com/contents/factitious-disorder-imposed-on-self-munchausen-syndrome

  Factitious disorder imposed on self is characterized by falsified general medical or psychiatric symptoms. Patients deceptively misrepresent, simulate, or cause symptoms of an illness and/or injury in themselves, even in the absence of obvious external rewards such as financial gain, housing, or medications. […] Early investigation of a possible factitious disorder can prevent patient self-harm as well as iatrogenic complications arising from unnecessary tests and treatments. […] This topic reviews the epidemiology, pathogenesis, clinical features, assessment, diagnosis, differential diagnosis, and management of factitious disorder imposed on self.

• #2 Factitious Disorder

  https://www.priory.com/psych/factitious.htm

  Diagnosis at discharge was factitious disorder with psychological signs and symptoms. […] Improving diagnosis is important for both clinics and research. From clinical point of view, it permits a better management or at least avoids unnecessary treatments. […] Based on analysis of cases reported in literature (see references) and on suggestions made by other authors (Pope et al 1982, Popli et al 1992) we propose the following guidelines for the diagnosis of factitious disorder with psychological signs and symptoms. […] It is obvious that such criteria are only suggestions and that further investigations and debates are likely to refine them. […] In this article we suggest, on the basis of case report analysis and proposals made by other authors more objective diagnostic criteria.

• #2 Epidemiology and evolution of the diagnostic classification of factiti | PRBM

  https://www.dovepress.com/epidemiology-and-evolution-of-the-diagnostic-classification-of-factiti-peer-reviewed-fulltext-article-PRBM

  This study lays the foundations for future research that could confirm or deny some hypotheses: first, the prevalence of psychiatric presentations among FD patients and, second, the correlation between FD and depressive syndrome that outlines the possibility of detailed diagnostic and therapeutic study.

• #2 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. […] Treatment is difficult and in many cases is not accepted by the patient. […] 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.

• #2 Kevin William Grant—Registered Psychotherapist – Behind the Illness Facade: Understanding Factitious Disorder

  https://www.kevinwgrant.com/blog/item/behind-the-illness-facade-understanding-factitious-disorder

  Recent studies have pointed to the under-diagnosis and under-detection of Factitious Disorder in clinical settings. […] Psychotherapy remains the primary treatment modality. However, there is increasing emphasis on early detection and intervention, employing a multidisciplinary approach that includes medical, psychiatric, and sometimes legal input. […] If left untreated, Factitious Disorder can have severe consequences for the individual, medically and psychologically, and for others involved, especially in Factitious Disorder Imposed on Another.

• #3 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. […] Factitious disorder symptoms can range from mild to severe. […] Factitious disorder isn’t the same as making up medical issues for a benefit or reward, such as getting out of work or winning a lawsuit. […] People with factitious disorder may know the risk of injury or even death when they hurt themselves or seek treatment that’s not needed. […] They also aren’t likely to seek help. […] Recognizing and treating factitious disorder may help avoid potentially dangerous tests and treatments that aren’t needed.

• #3 Factitious Disorder Imposed on Self (Munchausen Syndrome)

  https://my.clevelandclinic.org/health/diseases/9833-munchausen-syndrome-factitious-disorder-imposed-on-self

  Factitious disorder imposed on self, formerly known as Munchausen syndrome, happens when you falsify, create and/or exaggerate having symptoms of an illness that you dont really have. Diagnosing this condition is difficult, but treatment is available when youre ready. […] It can be difficult for healthcare providers to diagnose factitious disorder imposed on self. A healthcare provider will rule out possible physical and mental health conditions and verify diagnostic criteria. There needs to be clear evidence that youre falsifying or creating symptoms. A diagnosis usually happens after several diagnostic tests and procedures. A variety of healthcare providers work together to make a diagnosis. […] There isnt a specific test to diagnose factitious disorder imposed on self. Testing to rule out other conditions may include blood tests, urine tests, imaging tests and more.

• #3 Laboratory diagnosis of factitious disorders – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8042885/

  Self-induced factitious disorders are defined and distinguished from conditions they may resemble. […] Up to 5% of physician-patient encounters may be because of factitious disorders, but these are only suspected when the workup leads to contradictory findings. […] Laboratory tests are often the only definitive diagnostic method, and clinicians may not be familiar with current technologies. […] Discordant laboratory results should raise the possibility of a factitious disorder. […] Sophisticated laboratory tests that can accurately assay very small amounts of specific hormones or foreign substances in body fluids facilitate the diagnosis. […] The primary physician can now confirm an initial clinical diagnosis of factitious disorder promptly and directly rather than only by exclusion.

• #3 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. […] Falsification (i.e. – deliberately feigning) of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. […] The individual presents himself or herself to others as ill, impaired, or injured. […] The deceptive behaviour is evident even in the absence of obvious external rewards. […] The behaviour is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder. […] Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception.

• #3 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. […] Munchausen Disorder is another term for Factitious Disorder. […] This has the same diagnostic criteria as Factitious Disorder, seeking attention for being sick. […] To make this diagnosis, all 4 criteria must be met. 1. A pattern of falsification of physical or psychological signs or symptoms, associated with identified deception. […] 2. A pattern of presenting oneself to others as ill or impaired. 3. The behavior is evident even in the absence of obvious external rewards. 4. The behavior is not better accounted for by another mental disorder such as delusional belief system or acute psychosis.

• #3 Factitious disorders – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/695

  Factitious disorders are uncommon disorders in which the patient intentionally fabricates physical or psychological symptoms primarily for the purpose of deceiving healthcare providers and/or others. […] Factitious disorder is a syndrome in which signs and/or symptoms of disease are intentionally feigned, exaggerated, or self-induced by a patient when there is no clear principal external incentive for the behaviour. […] Distinguishing factitious disorder from related conditions can be a difficult task, particularly because they can sometimes co-exist in the same patient. […] Key diagnostic factors include presence of risk factors, history of unexplained complaints or inconsistency over time, and unusual presentation relative to demographics. […] Other diagnostic factors include symptoms more exaggerated while aware of being observed, presentation for care at many different hospitals, and eyewitness evidence of the patient manipulating findings. […] 1st investigations to order include clinical history and examination. […] Investigations to consider include cultures (e.g., blood or wound), serum C-peptide, urine sulphonylureas, urine electrolytes, urine protein, and serum thyroglobulin.

• #3 Munchausen syndrome | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/munchausen-syndrome

  Munchausen syndrome (also known as factitious disorder) is a rare type of mental disorder in which a person fakes illness. The person may lie about symptoms, make themselves appear sick, or make themselves purposely unwell. […] Diagnosis is difficult because a range of legitimate physical and mental illnesses must be ruled out first. To complicate matters further, a person with Munchausen syndrome tends to seek help from various health care providers to avoid tipping off any one doctor. Diagnosis, if it happens at all, may depend on abstract concepts such as: […] The persons symptoms dont make sense when compared with the test results. […] The person is unusually eager to undergo invasive medical procedures and operations. […] The person doesnt respond to treatments in a predictable fashion. […] Other people in the patients life dont confirm the persons symptoms.

• #3 Factitious disorders – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/695

  Factitious disorders are uncommon disorders in which the patient intentionally fabricates physical or psychological symptoms primarily for the purpose of deceiving healthcare providers and/or others. […] Factitious disorder is a syndrome in which signs and/or symptoms of disease are intentionally feigned, exaggerated, or self-induced by a patient when there is no clear principal external incentive for the behavior. […] Distinguishing factitious disorder from related conditions can be a difficult task, particularly because they can sometimes co-exist in the same patient. […] Key diagnostic factors include history of unexplained complaints or inconsistency over time and unusual presentation relative to demographics. […] Other diagnostic factors include symptoms more exaggerated while aware of being observed, presentation for care at many different hospitals, eyewitness evidence of the patient manipulating findings, dramatic history of travel and acute illness (Munchausen subtype), multiple abdominal scars (Munchausen subtype), and medications or medical paraphernalia found in an unusual location in a patient’s room. […] 1st tests to order include clinical history and exam. […] Tests to consider include cultures (e.g., blood or wound), serum C-peptide, urine sulfonylureas, urine electrolytes, urine protein, and serum thyroglobulin.

• #3 Münchhausen’s Syndrome: Symptoms and Treatment | Doctor

  https://patient.info/doctor/munchhausens-syndrome

  The deceptive behaviour is not solely motivated by obvious external rewards or incentives (eg, obtaining disability payments or evading criminal prosecution). This is in contrast to malingering, in which obvious external rewards or incentives motivate the behaviour. […] The behaviour is not better accounted for by another mental disorder (eg, schizophrenia or other primary psychotic disorder). […] If the diagnosis is suspected then investigation should be kept to a minimum. However, basic procedures for responding to the patient’s symptoms and signs generally need to be followed. […] Patients may interfere with samples – for example, putting blood in urine. They may also interfere with charts. […] They may ingest or inject themselves with toxic substances to produce abnormality. […] Be alert to inconsistencies in the history and symptoms and signs that do not seem to fit. […] Also remember that even people with Mnchhausen’s syndrome can suffer from genuine organic disease.

• #3 Factitious Disorder Imposed on Self (Munchausen’s Syndrome) Differential Diagnoses

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

  Factitious disorder must also be distinguished from somatic symptom disorder and conversion disorder. […] In practice, however, it may be impossible to distinguish between somatic symptom disorder and factitious disorder in patients who do not carry out physical simulations or self-injury that might provide concrete evidence of intentional deception. […] Patients with other psychiatric diagnoses can also present with somatic preoccupation that is not supported by findings from physical examination, laboratory testing, or imaging.

• #3

  https://link.springer.com/article/10.1007/s42399-019-00057-6

  In the factitious disorder (FD) on another, formerly called Munchausen syndrome by proxy (MSbP), one of the parents, the mother in 95% of the cases, fabricates or invents clinical symptoms in her child with the intention of convincing doctors and pediatricians that the child is sick. […] It is proposed that the psychopathological profile of the perpetrator of FD on another corresponds to an addictive disorder, in which the hospital context is compulsively sought, providing a high degree of gratification and reward.

• #3 Munchausen Syndrome by Proxy: Symptoms, Causes, and Treatment

  https://www.verywellmind.com/munchausen-by-proxy-5071840

  Factitious disorder imposed on another (FDIA) is a mental health disorder in which a caregiver, routinely makes up fake symptoms or causes real symptoms in a child, elderly person, disabled person, or even a pet, to make it appear that the victim has a true physical or mental health issue. […] Diagnosing FDIA is challenging for doctors because of all of the dishonesty presented by the adult caregiver. One core principle in diagnosing this disorder is that deception is present in all cases. According to the DSM-5-TR, methods of falsifying an illness in someone else can include exaggeration, fabrication, simulation, and induction. […] To meet a clinical diagnosis for FDIA, the following four criteria must be met: The perpetrator or caregiver engages in the deceptive falsification of physical or psychological signs or symptoms, or of induction of injury or disease in another; The person presents the victim to others as ill, injured, or impaired; The deceptive behavior is present in the absence of external incentives like money; The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.

• #3 Factitious Disorder: Detection, Diagnosis, and Forensic Implications

  https://www.psychiatrictimes.com/view/factitious-disorder-detection-diagnosis-and-forensic-implications

  The first issue is whether people with factitious disorder even qualify as patients who are entitled to treatment. […] The potential malpractice liability stemming from factitious disorder is unsettled. […] It may be very difficult to empathize with patients whose life experience has led them to the point where they feel that the best way to get their needs met is to falsify, exaggerate, aggravate, or self-induce symptoms.

• #3 Factitious Disorder vs. Malingering | Charlie Health

  https://www.charliehealth.com/post/factitious-disorder-vs-malingering

  Psychotherapy helps people control stress, develop coping skills, and understand the motivations behind their actions. […] Early diagnosis and intervention can significantly improve the prognosis for factitious disorder. […] If you suspect that you or a loved one may be dealing with factitious disorder or malingering, please seek advice from a mental healthcare provider. Both conditions have symptoms that drastically affect your quality of life and should be taken seriously.

• #3 Factitious Disorder: Recognizing and Addressing a Deceptive Behavior – Bangkok Mental Health Hospital

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

  Factitious disorder is a complex and deceptive mental health condition that requires careful diagnosis and individualized treatment. Understanding the underlying psychological motivations and providing appropriate support is essential for helping individuals break the cycle of deception and develop healthier coping mechanisms.

• #4

  https://link.springer.com/article/10.1007/s12024-020-00272-x

  Factitious disorders (FD) like Munchausen syndrome are well known to most physicians, yet the corresponding ICD-10 diagnosis F68.1 remains severely under-assigned and often misdiagnosed. […] The incidence of the diagnosis of FD in Germany and Norway showed similar assignment rates with 3.71 and 3.18 per 100,000, respectively. […] Despite the fact that Munchausen syndrome and other factitious disorders (FD) are well known to most physicians, the ICD-10 diagnosis F68.1 is severely under-assigned and misdiagnosed. […] The real incidence and distribution among the different medical specialties is still unknown and requires further studies. […] The identification of FD is complex, often time-consuming and requires systematic collection of relevant information, like a detailed chronology and thorough examination of the patients medical record.

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