Factitious Disorders

Louis, Dean S.; Kasdan, Morton L.

doi:10.1016/b978-1-4160-5279-1.00060-5

Cited by 2 publications

(3 citation statements)

References 24 publications

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“…However, the authoritative Green’s Operative Hand Surgery, authored by S.W. Wolfe and associates, does in fact include this disorder in its chapter on factitious disorders, published in 2011 [ 19 ]. Interestingly, neither of the two major textbooks in psychiatry mentions CFS in their most up-to-date editions [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Clenched fist syndrome: a case report

Nissen

Wynn

2018

J Med Case Reports

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BackgroundThe clenched fist syndrome/psycho-flexed hand, first described in the early 1980s, has not yet entered the major psychiatric textbooks. Curiously, the phenomenon has been illuminated mainly in journals and textbooks on hand surgery. There is a need to examine, describe, and understand this syndrome from a psychiatric perspective.Case presentationWe present a case we encountered in an intensive care unit. A 60-year-old white man with schizophrenia, cerebrovascular disease, diabetes mellitus type 2, and peripheral neuropathy, developed rather acutely bilateral clenched fists in the aftermath of a traumatic dislocated hip fracture that was operated on. He later died due to complications from the surgical procedure.ConclusionsWhile this was a complex case with some clinical uncertainty regarding the cause of our patient’s symptoms, we conclude that psychological processes were central to the development of his clenched fists. The phenomenon of clenched fists and our case are discussed with reference to the accumulated literature on psychogenic hand disorders and the International Statistical Classification of Diseases and Related Health Problems, 10th version. The nosological status appears to be obscure. This case presentation is a first step in increasing the understanding of this syndrome from a psychiatric perspective.

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Section: Discussionmentioning

confidence: 99%

Clenched fist syndrome: a case report

Nissen

Wynn

2018

J Med Case Reports

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“…The deliberateness and repetitiveness are driven by any or all of the following: desiring circumvention of or relief from an incompletely dissolved, corroding and intrusively obsessive guilt, craving to be understood and served under, enforcing care and relishing the resultant gratification, exhibiting masochism as a quencher of intrapsychic conflicts, 9,13 acquiring an emotional solace following loss of a family member or job, recreating childhood symptoms of illness or abuse -to forge a sense of control of situations, and occasionally a subconsciously driven vendetta against an acquaintance from the past, condensating in the present against similarbehaving caregivers or family members, especially those reminiscent of childhood abuser. 24 Perpetrators include early disruptive attachments, possible parental modelling, and identity conflicts. 13 Most of these scenarios indulge defenses like displacement, reaction formation and acting out, among others.…”

Section: Totalmentioning

confidence: 99%

“…The need for early pick-up of the diagnosis of factitious disorder is that misdiagnosis may result in a chronic course with costly and unwanted surgeries or medications which may result in permanent physical disabilities in the patient and physical and psychological strain in caregivers. 24 Correlation of factitiousness with compulsiveness and inflexibility as forms of persistence, and overt acting out, implies deployment of level III defenses including reaction formation. 29 Modeling, improvement of self-esteem, stigmatizing adoption of sick role, can deter from feigning, besides appropriate psychoeducation on social complications including risk of abandonment by caregivers and family members upon revelation of the patient's true intentions.…”

Section: Managementmentioning

confidence: 99%

A Study on Traits and Gains in Factitious Disorder, and a New Self-Report Rating Scale

Kumar¹,

Raaj²

2019

jebmh

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BACKGROUNDFactitious disorder is a psychiatric diagnosis presenting with feigning of illness, lying in the continuum of somatoform and dissociative disorders through to malingering. Symptoms overlap as traits and gains confound the diagnosis. We wanted to study the pattern of sociodemographic distribution and types of gains between groups of patients with factitious and dissociative disorders, the intensity of factitiousness, masochism and compulsiveness among the two groups, and correlation between the traits. METHODSA cross-sectional observational study with convenience sampling, with consenting patients with factitious disorder and dissociative disorders, attending the outpatient unit in July 2017 to April 2018 period in the Department of Psychiatry in this tertiary teaching hospital, following institutional ethical committee clearance was undertaken. After case to case matching of patients between the two groups for major types of presenting symptoms, 30 patients in each group were considered for the study. Sociodemographic profile, a self-structured 22 item self-report rating scale for factitious disorder, Yale-Brown Obsessive-Compulsive Scale, and Masochism personality disorder criteria (DSM-III-R) were the tools used. Appropriate descriptive statistics with chi squared and t-tests and correlation coefficients were used. RESULTSAbout 67% and 63% had motor symptoms and 20% and 26.7% had cardiorespiratory symptoms in the two groups. Emotional gains were predominant in two-thirds of patients in both groups. Factitious patients had high scores in a new factitious intensity (FAC22-SR) scale and YBOCS, and mild score in masochism traits. CONCLUSIONSGains have been proved as the driving force in conversion as well as factitious disorder. Early diagnosis of factitious disorder is important as misdiagnosis results in a chronic course with costly complications. Addressing obsessive compulsiveness, and masochist behavioural attributes may improve prognosis.

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Factitious Disorders

Cited by 2 publications

References 24 publications

Clenched fist syndrome: a case report

Clenched fist syndrome: a case report

A Study on Traits and Gains in Factitious Disorder, and a New Self-Report Rating Scale

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