Paternalism and factitious disorder: medical treatment in illness deception

2015 ◽  
Vol 22 (4) ◽  
pp. 565-574 ◽  
Author(s):  
Anthony Fry ◽  
Tania L. Gergel
2017 ◽  
Author(s):  
James Amos ◽  
Michael Strong ◽  
Donald W. Black

Factitious disorder (FD) is a psychiatric disorder in which patients deliberately perpetrate or lie about medical and/or psychiatric illness in themselves or others. Although it has been thought to be driven by the need to take the patient role, no body of research has clearly identified the underlying motivation, cause, or treatment for it. Illness deception, along with the similarity to other diagnostic categories, such as somatic symptom disorder, personality disorder, and malingering (which is not considered a mental illness but can be a focus of clinical attention), has hindered basic and clinical research into the nature and treatment of FD. Still, moving psychiatric treatment of FD forward can take advantage of tools already available to clinicians, including motivational interviewing techniques to facilitate empathic confrontation in the general hospital. Despite the lack of treatment studies, employing therapies known to be effective for borderline personality disorder, which is similar in many ways to FD, for FD patients willing to participate might be helpful. This review contains 4 figures, 5 tables and 26 references Key words: factitious disorder imposed on another, factitious disorder imposed on self, malingering, medically unexplained symptoms, Munchausen by proxy, Munchausen syndrome, pseudologia fantastica, somatic symptom disorders 


1983 ◽  
Vol 14 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Betty U. Watson ◽  
Ronald W. Thompson

The purpose of this study was to evaluate parents' reactions and understanding of diagnostic information from written reports and conferences in a clinic which provides multidisciplinary evaluations for children with speech, learning, language, and hearing problems. Previous studies and anecdotal reports suggested that many parents do not receive appropriate diagnostic information about their children. In the present study questionnaires were mailed to parents who had received reports of evaluations and most of whom had attended hour-long conferences covering the findings. Questionnaires were also sent to professionals who had received reports. Fifty-seven percent of the parents, and 63% of the professionals returned the questionnaires. Ninety percent of the parents indicated that they had understood the results as they were presented in the conference. Ninety-three percent of the professionals and 89% of the parents stated they understood the conclusions of the written reports .Further, 83% of the parents and 80% of the professionals reported that the findings had made a change in the child's educational or medical treatment. The percentage of parents who reported understanding the findings was greater than expected. The specific informing techniques used in this study are discussed.


2005 ◽  
Vol 38 (2) ◽  
pp. 68
Author(s):  
Jane Salodof MACNeil

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.


VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0220-0228 ◽  
Author(s):  
Marion Vircoulon ◽  
Carine Boulon ◽  
Ileana Desormais ◽  
Philippe Lacroix ◽  
Victor Aboyans ◽  
...  

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. Patients and methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). Results: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). Conclusions: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).


Sign in / Sign up

Export Citation Format

Share Document