Factitious Disorder Presenting as the Intentional Swallowing of Foreign Objects

Abstract

Background: Factitious disorder (FD) imposed on self is a psychiatric disorder characterized by the intentional feigning of symptoms or the self-inflicted production of symptoms in the absence of an obvious external reward. Case: This report describes a severe case of FD imposed on self in a 31-year-old male who frequently presented to several regional Emergency Departments with intentional ingestion of foreign objects, ultimately requiring 32 esophagogastroduodenoscopy (EGD) and 28 gastroscopy procedures over two years. Significant history of frequent suicide attempts via medication overdose and clinical suspicion of drug-seeking behavior complicated the case. Motivating factors for the patient’s behavior, suicidality in FD, and thepatient’s treatment and outcome to date will be discussed. Conclusion: There is no well-established treatment for FD documented in the literature. High-quality studies and additional reports of FD could help clinicians when managing such a challenging diagnosis.