Overview
Factitious disorder imposed on self, formerly known as Munchausen syndrome, involves patients intentionally fabricating or inducing physical or psychological symptoms for the purpose of assuming the role of a sick person. 2Diagnosis
Key Diagnostic Criteria: Intent to assume the sick role, feigning or producing symptoms, absence of external incentives for feigning illness 2
Recommended Tests: No specific laboratory tests; diagnosis primarily clinical, involving thorough history and observation 2
Grading: Not typically graded; diagnosis based on clinical judgment and exclusion of other conditions 2Management
First-line Treatments: Psychotherapy, particularly psychodynamic therapy and cognitive-behavioral therapy 2
Adjunctive Treatments: Medications for comorbid psychiatric conditions (e.g., depression, anxiety) as needed 2
Specific Drug Classes: Not specified in provided abstracts 2Special Populations
Pregnancy: Limited evidence; management focuses on psychiatric support and monitoring 2
Pediatrics: Care involves safeguarding the child and addressing underlying psychological issues 2
Elderly: Requires careful assessment to differentiate from genuine medical conditions 2
Comorbidities: Focus on integrated psychiatric care alongside management of other health issues 2Key Recommendations
Prioritize Psychotherapeutic Interventions for addressing underlying psychological motivations (Evidence: Expert opinion) 2
Ensure Comprehensive Clinical Assessment to rule out other medical conditions before diagnosis (Evidence: Expert opinion) 2
Provide Supportive Care for Comorbid Conditions, especially psychiatric comorbidities, using appropriate pharmacotherapy when necessary (Evidence: Expert opinion) 2References
1 Cortegiani A, Manca A, Giarratano A. Predatory journals and conferences: why fake counts. Current opinion in anaesthesiology 2020. link
2 Hull AJ. Fictional father?: Oliver Sacks and the revalidation of pathography. Medical humanities 2013. link