Factitious Disorder in Seven Patients: A Saudi Experience

Abstract

BackgroundFactitious disorder (FD) is a psychiatric disease where signs and symptoms are produced, falsified, or exaggerated consciously in the absence of clear external motivations. Through needless medical visits, costly investigatory testing, and potentially long hospital stays, patients with FD waste valuable time and resources, which affects both the patient and the healthcare system. It can be very challenging for physicians who have never encountered patients with FD to recognize them promptly as symptoms of FD vary greatly. MethodologyThis was a retrospective study of patients diagnosed with FD attending King Abdulaziz Medical City in Riyadh, Saudi Arabia, a tertiary care military hospital and one of the most prominent academic and referral medical institutions in the country. Using the BESTCare health information system, we reviewed patients' electronic health records from January 2015 to December 2020. The diagnosis of FD was based on the International Classification of Diseases and Related Health Problems 10th edition. ResultsA total of seven patients were included in the study, of whom five (71%) were males and two (29%) were females. Of the total seven patients, three were 21 years old and younger, one was 38 years old, and three were 56 years old and older. Three (43%) patients were married and four (57%) were single. In terms of occupation, three (43%) patients were retired, one (14%) worked in a private company, one (14%) was unemployed, and two (29%) were students. A total of four (57%) patients initially presented to the Emergency Department (ED), and only three (43%) presented to the outpatient clinics. Induced disease or injury was found in five (71%) patients. Induced skin injury was found in four (57%) patients. Counseling and psychotherapy were only offered to one (14%) patient. ConclusionsFD remains a rare psychiatric condition that is difficult to recognize. Despite a small sample size, FD in the present study showed a male predominance, affecting patients of all age groups. About half of the patients presented initially to the ED. Induced disease or injury was the most commonly reported pattern of clinical presentation. Induced skin injury was the most common clinical presentation found in around half of the patients. We believe that the number of FD patients in the present study is likely underreported and is expected to be higher. This highlights the need for better awareness of FD among physicians in different medical fields. We emphasize that there is a need for better professional training in the identification of FD.

Nhận Xét Đặc Điểm Lâm Sàng Của Rối Loạn Giả Bệnh Ở Nam Quân Nhân

“…Kết quả này phù hợp với nghiên cứu trước đây thông qua việc phân tích 455 trường hợp được chẩn đoán rối loạn giả bệnh từ nhiều nguồn tài liệu chuyên khoa, kết quả cho thấy rối loạn tâm thần phổ biến nhất liên quan đến rối loạn giả bệnh là trầm cảm (41,8%) [6]. Một nghiên cứu khác về rối loạn giả bệnh tại một Bệnh viện Quân đội ở Ả Rập Saudi cho kết quả khoảng 14% các trường hợp giả các triệu chứng của trầm cảm, phần lớn (57%) là có tổn thương da tự tạo, đa số được phát hiện tại Khoa Cấp cứu ban đầu trong bệnh viện [7]. Trầm cảm là bệnh lý dễ làm giả bởi vì các triệu chứng của trầm cảm hầu hết là các triệu chứng chủ quan do bệnh nhân cung cấp.…”