Münchhausen Syndromes and Factitious Diseases

Plassmann, Reinhard

doi:10.1159/000288899

Cited by 35 publications

(26 citation statements)

References 29 publications

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“…According to a bio-psychosocial model and as confirmed by the literature, this finding, although not an absolute majority in patients of this study, suggests that a healthcare work can be a risk factor in the development of factitious disorder if associated to other stressful life events [11,14].…”

Section: Discussionsupporting

confidence: 77%

A Systematic Review on Factitious Disorders: Psychopathology and Diagnostic Classification

Caselli¹,

Poloni²,

Ceccon³

et al. 2018

Neuropsychiatry

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Factitious disorder (FD) is a psychiatric disorder in which sufferers intentionally fabricate physical or psychological symptoms in order to assume the role of the patient, without any obvious gain. The clinical and demographic profile of patients with FD has not been sufficiently clarified. The aims of this study are: to outline a demographic and clinical profile of a large sample of patients with FD, to highlight the psychopathological correlates and to study the evolution of position of FD in the DSM. A systematic search for all case reports and case series of adult patients in the databases MEDLINE, Scopus and PsycINFO was conducted. 1636 records were obtained based on key search terms, after exclusion of duplicate records. 577 articles were identified as potentially eligible for the study, of which 314 studies were retrieved for full-text review. These studies included 514 cases. Variables extracted included age, gender, reported occupation, comorbid psychopathology, clinical presentation and factors leading to the diagnosis of FD. 64.5% of patients in the sample were females. Mean age at presentation was 33.5 y.o. A healthcare profession was reported most frequently (n=113). Patients were most likely to present in psychiatry, neurology, emergency and internal medicine departments. Statistical analysis has highlighted significant correlations between factitious disorders and depressive disorders and borderline personality disorder (BPD) and a significant effect of BPD and abuses in childhood on substance abuse. The survey of socio-demographic profile of the sample has highlighted some important points for early diagnosis and early psychiatric treatment. The research also allows deepening the psychopathological correlates of the disorder. The study showed that patients did not meet DSM-5 diagnostic criteria in the 11.3% of cases.

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Section: Discussionsupporting

confidence: 77%

A Systematic Review on Factitious Disorders: Psychopathology and Diagnostic Classification

Caselli¹,

Poloni²,

Ceccon³

et al. 2018

Neuropsychiatry

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“…Autodestructive syndromes are at times striking for the direct, indirect or combined methods of patient self-manipulation they involve [1,2,3,4,5] and examples have been reported from numerous fields of medicine [6,7,8,9]. …”

Section: Methodsmentioning

confidence: 99%

“…The intention of the patient remains concealed here. Indeed, the severest and chronic form is known as Munchausen’s syndrome [2, 5,20,21,22]. In many cases, up to 6–10 years may elapse before a first diagnosis is made and it is therefore only possible to estimate the level of financial and manpower resources [23, 24].…”

Section: Methodsmentioning

confidence: 99%

Autodestructive Syndromes

Kocalevent

Fliege

Rose

et al. 2005

Psychother Psychosom

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Background: The phenomenon ‘autodestructive behaviour’ is becoming an increasingly serious disease and cost factor in a wide range of medical fields. The present paper presents a survey of the literature on autodestructive behaviour, excluding psychotic, substance-induced or organic brain disorders. Starting out with a conceptual overview, the paper goes on to look into the epidemiology of autodestructive behaviour and the forms in which it manifests itself. Method: A literature search was conducted in Medline, Psycinfo and Psyndex using the search terms ‘artifact’, ‘artificially induced’, ‘autodestructive’, ‘self-mutilation’, ‘factitious’, ‘self-harm’, ‘self-induced’, ‘self-inflicted’, ‘self-injuring’ and ‘self-mutilation’ for the period from 1977 to 2003. Results: Five of a total of 18 empirical studies describe the simultaneous occurrence of direct and indirect forms of autodestructive behaviour. Reported prevalence rates range from 0.032% to 9.36%. The ratio of females to males was found to be 2:1 (average age: 31.5 years; SD: 9.3 years); in contrast, the gender ratio was reversed for Munchausen’s syndrome. The case history data presented are patchy and differ in terms of their priorities. We found a large number of codiagnoses, which seems to indicate that personality and dependence disorders, or substance misuse, are characteristic of both direct and indirect forms of autodestructive behaviour. Conclusions: The task at hand is to use a yet-to-be-developed nomenclature and adequately operational diagnostic criteria to work out standardised survey instruments that do justice to the heterogeneity of this disorder complex.

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“…Plassmann 1996). Dass sie ihr eigenes Beziehungsverhalten ähnlich wie das der Therapeutin einschätzte,wurde als Hinweis für den Wunsch der Patientin nach Identifizierung mit der Therapeutin verstanden.Hingegen schien sie die Mutter zum Ende der Behandlung ansatzweise entidealisiert zu haben, wenn sich auch insgesamt am destruktiven Bild wenig änderte.Das verdeutlicht,dass eine stationäre Behandlung zwar grundlegende Schritte hinsichtlich Beziehungsaufbau und affektivem Zugang leisten kann, aber die Bearbeitung zugrunde liegender Traumata,die Voraussetzung für den Aufbau konstruktiver Beziehungsformen wäre, einer längerfristigen Psychotherapie vorbehalten bleibt (Plassmann 1994).…”

Section: Diskussionunclassified

Behandlungstechnische Probleme bei artifiziellen St�rungen

2004

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Obwohl das Krankheitsbild der artifiziellen Störung seit ca. 150 Jahren bekannt ist und seit Asher (1951) viele Male beschrieben wurde,stellt es noch immer eine große Herausforderung sowohl in der somatischen als auch in der psychosomatischen Medizin dar. Hinsichtlich des typischen Krankheitsverlaufs,möglicher Komplikationen und Schäden für Patienten sowie der oft unüberwindbaren Schwierigkeiten im Umgang mit diesen konnte bisher kein wesentlicher Fortschritt erzielt werden (Eckhardt-Henn 1999).

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Münchhausen Syndromes and Factitious Diseases

Cited by 35 publications

References 29 publications

A Systematic Review on Factitious Disorders: Psychopathology and Diagnostic Classification

A Systematic Review on Factitious Disorders: Psychopathology and Diagnostic Classification

Autodestructive Syndromes

Behandlungstechnische Probleme bei artifiziellen St�rungen

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