Inpatient and Outpatient Long-Term Psychotherapy of Patients Suffering from Factitious Disorders

Plassmann, Reinhard

doi:10.1159/000288910

Cited by 33 publications

(13 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Seven (53.8%) did not follow-up all patients in the series, which may confound the evidence that they present. Two (15.4%) reported outcomes as assessed by another clinician [52, 55], and one paper used a standardised scale (the Malan scale) to assess the change in patient condition [56]. …”

Section: Resultsmentioning

confidence: 99%

“…Many reported techniques were multidisciplinary in nature [56, 61]. Plassmann [56] described a long-term psychotherapeutic approach which had its foundations in the treatment of borderline personality disorder; patients initially received inpatient clinical psychotherapy followed by outpatient psychotherapy which had lasted up to 5 years at the time of reporting.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Management of Factitious Disorders: A Systematic Review

Eastwood

Bisson

2008

Psychother Psychosom

View full text Add to dashboard Cite

Background: The literature regarding the management of factitious disorder (FD) is diverse and generally of case reports or case series. To date there has been no systematic review of the effectiveness of management techniques. Methods: Systematic review of all evidence reporting the management and subsequent outcome in FD. Data were extracted and outcomes were assessed using an adaptation of the Global Improvement Scale. Results were analysed by parametric statistical tests; a meta-analysis was not possible. Results: Thirty-two case reports and 13 case series were eligible for inclusion. Analysis of the case reports found no significant difference in outcomes between confrontational and non-confrontational approaches [t(29) = 0.72, p = 0.48], between treatment with psychotherapy compared to no psychotherapy [t(30) = 0.69, p = 0.48], and when psychiatric medication had been prescribed compared with not [t(30) = 0.35, p = 0.73]. A trend was observed that a longer length of treatment lead to better outcomes, but this was not significant [F(5, 26) = 1.17, p = 0.35]. The consecutive case series demonstrated that many FD sufferers were not engaged in treatment and were lost to follow-up but did not provide any strong evidence regarding the effectiveness of different management approaches. Conclusions: There is an absence of sufficient robust research to determine the effectiveness of any management technique for FD. The establishment of a central reporting register to facilitate the development of evidence-based guidelines is recommended.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Management of Factitious Disorders: A Systematic Review

Eastwood

Bisson

2008

Psychother Psychosom

View full text Add to dashboard Cite

show abstract

“…In-patient treatment is more costly than outpatient psychotherapy, but its effect is considerably more intensive, since the patient is treated at various levels by an integrated team of doctors, psychologists, special therapists and nurses. In individual therapy, the patient can experience stabilizing safety and individual attention, in group psychotherapy, the patient's psychosocial difficulties with other people can be worked out on a confrontational basis yet in the structured and protective conditions of the clinic [Plassmann, 1994;Sachsse, 1994]. If these psychodynamic processes lead to a differentiated perception of self and others, and to better affect regulation, it will enable the patient to dispense with self-destructive reactions, better control his emotional impulses and instead to articulate conflicts and needs in a psychosocially more adequate way.…”

Section: Affect and Behavior Modificationmentioning

confidence: 99%

“…The prognosis, especially for artefact patients, is not considered favorable. With reference to treatment with in-patient psychotherapy, there are two publications which describe partial therapeutic success [Plassmann, 1994;Sachsse, 1994]. In general, knowledge of the cause, treatment results and prognosis in the psychotherapy of patients with self-inflicted dermatological injuries is rated unsatisfactory [Koblenzer, 2000].…”

Section: Introductionmentioning

confidence: 99%

Personality Typology and Treatment Phases in Patients with Self-Inflicted Dermatological Injuries

Konzag¹,

Baumgartner²,

Fikentscher³

et al. 2004

Dermatol Psychosom

View full text Add to dashboard Cite

Background: The prognosis of patients with self-inflicted dermatological injuries has been rated unfavorable. To motivate the patients to accept psychotherapy is often difficult and requires close cooperation between dermatologists and psychotherapists. The present study comprises personality typology and the course of treatment of patients with self-inflicted dermatological injuries treated at the University Clinic for Psychotherapy and Psychosomatics in Halle over a two-year period. Patients and Methods: 18 patients receiving in-hospital integrative psychotherapy were examined at the beginning and 2 years after completion of therapy. Focus was on recording of psychopathology, psychodynamics, the doctor-patient relationship and the documentation of risk and protective factors. Results: The self-inflicted injuries usually occurred in the context of personality disorders. Psychodymanics enabled differentiation of two subgroups: a subgroup of patients who had grown up in an existentially threatening milieu in which physical integrity was violated and a subgroup subjected at the emotional level to experiences of withholding and aggression. The structuring of a three-phase treatment concept was an essential prerequisite to long-lasting improvement in symptoms.

show abstract

“…Betrachtet man wie Bock [2] die beiden aktuellen deutschen Therapiestudien zum Factitia-Syndrom von Freyberger et al [11] und von Plassmann [16], so sind die Ergebnisse einer Psychotherapie mäßig: Nur 31% von 94 Patienten willigten in eine Langzeitpsychotherapie ein, und nur bei 13% verlief sie nach mehreren Jahren erfolgreich. Folks [10] betonte, dass den meisten Fallberichten über erfolgreich behandelte artifizielle Störungen drei therapeutische Ansätze gemeinsam waren: 1. positives Gesundheitsverhalten verstärken, 2. die Rolle eines Haupttherapeuten hervorheben und 3. eine beständige Beziehung zu einem Arzt ungeachtet des therapeutischen Erfolgs aufrechtzuerhalten.…”

unclassified