Showing posts with label factitious disorder. Show all posts
Showing posts with label factitious disorder. Show all posts

Tuesday, May 05, 2009

Amateur Pshrink V



I am pretty partial to this disorder too. I feel just like this lady looks in the picture, much of the time. Only doing other things distracts me from sometimes tearing my hair out with tears of despair and hopelessness.
I like all of the DSM disorders, as a matter of fact. I am thinking of collecting them, like baseball cards...


Somatoform disorder (also known as Briquet's syndrome) is a psychological disorder characterized by physical symptoms that mimic disease or injury for which there is no identifiable physical cause or physical symptoms such as pain, nausea, depression, and dizziness. Somatoform disorder is a condition in which the physical pain and symptoms a person feels are related to psychological factors. These symptoms can not be traced to a specific physical cause. In people who have Somatoform disorder, medical test results are either normal or don't explain the person's symptoms. People who have this disorder may undergo several medical evaluations and tests to be sure that they do not have an illness related to a physical cause or central lesion. Patients with this disorder often become very worried about their health because the doctors are unable to find a cause for their health problems. Their symptoms are similar to the symptoms of other illnesses and may last for several years. People who have Somatoform disorder are not faking their symptoms. The pain that they feel is real, and they feel what they say they are feeling.

A person faking their symptoms may have factitious disorder (an unknown psychological cause for making oneself sick) or malingering (making oneself sick for personal or monetary gain; i.e. disability, insurance, etc). This is not at all related to the Somatoform Disorder, however.
A diagnosis of a Somatoform disorder implies that psychological factors are a large contributor to the symptoms' onset, severity and duration. It is important to note that Somatoform disorders are not the result of conscious malingering or factitious disorders.
The Somatoform disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association are:
Included among these disorders are false pregnancy, psychogenic urinary retention, and mass psychogenic illness (so-called mass hysteria).
  • Somatoform disorder NOS
Additional proposed somatoform disorders are:
  • Abridged somatization disorder - at least 4 unexplained somatic complaints in men and 6 in women
  • Multisomatoform disorder - at least 3 unexplained somatic complaints from the PRIME-MD scale for at least 2 years of active symptoms
These disorders have been proposed because the recognized somatoform disorders are either too restrictive or too broad. In a study of 119 primary care patients, the following prevalences were found:
  • Somatization disorder - 1%
  • Abridged somatization disorder - 6%
  • Multisomatoform disorder - 24%
  • Undifferentiated somatoform disorder - 79%
In my case, I suspect false pregnancy would be tough to carry out, and right now I´d settle for a reasonable duration of urinary retention prior to wetting my diapers.


But in other words, we can´t explain what is wrong, but we gotta tell the insurance company something, so we made up this fancy title that means ¨we don´t know what is wrong, but this fella is REAALLY SICK!¨


Wednesday, April 29, 2009

Amateur Pshrink III



This one sounds like fun too! I wanna get all of em!

Better than collecting old comic books!


Münchausen syndrome is a psychiatric disorder in which those affected feign disease, illness, or psychological trauma in order to draw attention or sympathy to themselves. It is in a class of disorders known as factitious disorders which involve "illnesses" whose symptoms are either self-induced or falsified by the patient. It is also sometimes known as hospital addiction syndrome.
In Münchausen syndrome, the affected person exaggerates or creates symptoms of illnesses in themselves or their child/children in order to gain investigation, treatment, attention, sympathy, and comfort from medical personnel. In some extremes, people suffering from Münchausen's Syndrome are highly knowledgeable about the practice of medicine, and are able to produce symptoms that result in multiple unnecessary operations. For example, they may inject a vein with infected material, causing widespread infection of unknown origin, and as a result cause lengthy and costly medical analysis and prolonged hospital stay. The role of "patient" is a familiar and comforting one, and it fills a psychological need in people with Münchausen's. It is distinct from hypochondriasis in that patients with Münchausen syndrome are aware that they are exaggerating, whereas sufferers of hypochondriasis believe they actually have a disease.
In 1951, Richard Asher was the first to describe a pattern of self-harm, where individuals fabricated histories, signs, and symptoms of illness. Remembering Baron Münchausen, Asher named this condition Münchausen's Syndrome in his article in The Lancet in February 1951, quoted in his obituary in the British Medical Journal:
"Here is described a common syndrome which most doctors have seen, but about which little has been written. Like the famous Baron von Münchausen, the persons affected have always travelled widely; and their stories, like those attributed to him, are both dramatic and untruthful. Accordingly the syndrome is respectfully dedicated to the Baron, and named after him."
—British Medical Journal, R.A.J. Asher, M.D., F.R.C.P.
Originally, this term was used for all factitious disorders. Now, however, there is considered to be a wide range of factitious disorders, and the diagnosis of "Münchausen syndrome" is reserved for the most severe form, where the simulation of disease is the central activity of the affected person's life.

Risk factors for developing Münchausen syndrome include childhood traumas, and growing up with caretakers who, through illness or emotional problems, were unavailable.
Medical professionals suspecting Münchausen's in a patient should first rule out the possibility that the patient does indeed have a disease state, but it is in an early stage and not yet clinically detectable. Providers need to acknowledge that there is uncertainty in treating suspected Münchausen patients, so that real diseases are not under treated. Then they should take a careful patient history, and seek medical records, to look for early deprivation, childhood abuse, mental illness.
Medical professionals should avoid surgical and diagnostic procedures, if they do not seem absolutely warranted – this may well anger the Münchausen patient who seeks out such procedures and attention. At the same time, providers should attempt to form an alliance with the patients, identifying with the emotional pain they may have suffered leading to this behavior.
Medical providers should consider working with mental health specialists to help treat the underlying mood or disorder and well as to avoid countertransference, Therapeutic and medical treatment should center on the underlying psychiatric disorder: a mood disorder, an anxiety disorder or borderline personality disorder. The patient's prognosis depends upon the category under which the underlying disorder falls; depression and anxiety, for example, generally respond well to medication and/or cognitive behavioral therapy, whereas borderline personality disorder, like all personality disorders, is presumed to be pervasive and more stable over time [5], thus offers the worst prognosis.
If a patient is at risk to himself or herself, inpatient psychiatric hospitalization should be initiated.

Illnesses and conditions commonly feigned by Münchausen patients

Note that many of these conditions do not have clearly observable or diagnostic symptoms.

See also