0
0

Chapter 41. Factitious Disorder and Malingering

James C. Hamilton, Ph.D.; Marc D. Feldman, M.D.
DOI: 10.1176/appi.books.9781585622986.260630

Sections

Excerpt

Factitious disorder and malingering are characterized by attempts to assume the sick role by exaggerating, lying about, simulating, aggravating, or inducing illness. Despite the lack of concrete evidence-based guidance on the care of patients with these behavior patterns, health professionals are nevertheless expected to protect and promote the patients' physical and psychological well-being. In this chapter we attempt to present advice on how to accomplish this goal.

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

References

Allen LA, Woolfolk RL, Lehrer PM, et al: Cognitive behavior therapy for somatization disorder: a preliminary investigation. J Behav Ther Exp Psychiatry 32:53–62, 2001
[PubMed]
 
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition. Washington, DC, American Psychiatric Association, 1980
 
Arnold IA, Speckens AE, van Hemert AM: Medically unexplained physical symptoms: the feasibility of group cognitive-behavioural therapy in primary care. J Psychosom Res 57:517–520, 2004
[PubMed]
 
Axen D: Chronic factitious disorders: helping those who hurt themselves. J Psychosoc Nurs Ment Health Serv 24:19–20, 25–27, 1986
 
Dworkin SF, Turner JA, Mancl L, et al: A randomized clinical trial of a tailored comprehensive care treatment program for temporomandibular disorders. J Orofac Pain 16:259–276, 2002
[PubMed]
 
Earle JR Jr, Folks DG: Factitious disorder and coexisting depression: a report of successful psychiatric consultation and case management. Gen Hosp Psychiatry 8:448–450, 1986
[PubMed]
 
Ehlers W, Plassmann R: Diagnosis of narcissistic self-esteem regulation in patients with factitious illness (Munchausen syndrome). Psychother Psychosom 62:69–77, 1994
[PubMed]
 
Ehlert U, Wagner D, Lupke U: Consultation-liaison service in the general hospital: effects of cognitive-behavioral therapy in patients with physical nonspecific symptoms. J Psychosom Res 47:411–417, 1999
[PubMed]
 
Eisendrath SJ: Factitious physical disorders: treatment without confrontation. Psychosomatics 30:383–387, 1989
[PubMed]
 
Eisendrath SJ: Factitious disorders and malingering, in Treatments of Psychiatric Disorders, 3rd Edition. Edited by Gabbard GO. American Psychiatric Publishing, 2001, pp 1825–1842
 
Eisendrath SJ, Feder A: Management of factitious disorders, in Spectrum of Factitious Disorders. Edited by Feldman MD, Eisendrath SJ. Washington, DC, American Psychiatric Press, 1996, pp 195–213
 
Feldman MD: Prophylactic bilateral radical mastectomy resulting from factitious disorder. Psychosomatics 42:519–521, 2001
[PubMed]
 
Feldman MD: Playing Sick? Untangling the Web of Munchausen Syndrome, Munchausen by Proxy, Malingering, and Factitious Disorder. New York, Brunner-Routledge, 2004
 
Feldman MD, Eisendrath SJ: The Spectrum of Factitious Disorders. Washington, DC, American Psychiatric Press, 1996
 
Feldman MD, Smith R: Personal and interpersonal toll of factitious disorders, in Spectrum of Factitious Disorders. Edited by Feldman MD, Eisendrath SJ. Washington, DC, American Psychiatric Press, 1996, pp 175–194
 
Grenga TE, Dowden RV: Munchausen's syndrome and prophylactic mastectomy. Plast Reconstr Surg 80:119–120, 1987
[PubMed]
 
Hiller W, Fichter MM, Rief W: A controlled treatment study of somatoform disorders including analysis of healthcare utilization and cost-effectiveness. J Psychosom Res 54:369–380, 2003
[PubMed]
 
Huffman JC, Stern TA: The diagnosis and treatment of Munchausen's syndrome. Gen Hosp Psychiatry 25:358–363, 2003
[PubMed]
 
Kinsella P: Factitious disorder: a cognitive behavioural perspective. Behavioural and Cognitive Psychotherapy 29:195–202, 2001
 
Klonoff EA, Youngner SJ, Moore DJ, et al: Chronic factitious illness: a behavioral approach. Int J Psychiatry Med 13:173–183, 1983
[PubMed]
 
Kroenke K, Swindle R: Cognitive-behavioral therapy for somatization and symptom syndromes: a critical review of controlled clinical trials. Psychother Psychosom 69:205–215, 2000
[PubMed]
 
Kupfermann K, Aron L, Anderson FS: Cancer as a factitious disorder (Munchausen syndrome) related to body self-image and object relations in a borderline patient, in Relational Perspectives on the Body. Edited by Aron L, Anderson FS. Mahwah, NJ, Analytic Press, 1998, pp 139–171
 
Looper KJ, Kirmayer LJ: Behavioral medicine approaches to somatoform disorders. J Consult Clin Psychol 70:810–827, 2002
[PubMed]
 
Mayo JP, Haggerty JJ: Long-term psychotherapy of Munchausen syndrome. Am J Psychother 38:571–578, 1984
[PubMed]
 
Oh CC, McKenna DB, McLaren KM, et al: Factitious panniculitis masquerading as pyoderma gangrenosum. Clin Exp Dermatol 30:253–255, 2005
[PubMed]
 
Plassmann R: The biography of the factitious-disorder patient. Psychother Psychosom 62:123, 1994a
 
Plassmann R: Inpatient and outpatient long-term psychotherapy of patients suffering from factitious disorders. Psychother Psychosom 62:96–107, 1994b
 
Prior TI, Gordon A: Treatment of factitious disorder with pimozide. Can J Psychiatry 42:532, 1997
[PubMed]
 
Schwarz K, Harding R, Harrington D, et al: Hospital management of a patient with intractable factitious disorder. Psychosomatics 34:265–267, 1993
[PubMed]
 
Servan-Schreiber D, Tabas G, Kolb R: Somatizing patients, part II: practical management. Am Fam Physician 61:1423–1428, 1431–1432, 2000
 
Shapiro AP, Teasell RW: Behavioural interventions in the rehabilitation of acute vs. chronic non-organic (conversion/factitious) motor disorders. Br J Psychiatry 185:140–146, 2004
[PubMed]
 
Smith GR Jr, Miller LM, Monson RA: Consultation-liaison intervention in somatization disorder. Hosp Community Psychiatry 37:1207–1210, 1986a
 
Smith GR Jr, Monson RA, Ray DC: Psychiatric consultation in somatization disorder: a randomized controlled study. N Engl J Med 314:1407–1413, 1986b
 
Solyom C, Solyom L: A treatment program for functional paraplegia/Munchausen syndrome. J Behav Ther Exp Psychiatry 21:225–230, 1990
[PubMed]
 
Stone J, Carson A, Sharpe M: Functional symptoms in neurology: management. J Neurol Neurosurg Psychiatry 76 (suppl):i13–i21, 2005
 
Teasell R, Shapiro A: Strategic-behavioral intervention in the treatment of chronic nonorganic motor disorders. Am J Phys Med Rehabil 73:44–50, 1994
[PubMed]
 
Yanik M, San I, Alatas N: A case of factitious disorder involving menstrual blood smeared on the face. Int J Psychiatry Med 34:97–101, 2004
[PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 14.  >
The American Psychiatric Publishing Textbook of Psychiatry, 6th Edition > Chapter 16.  >
Topic Collections
Psychiatric News
PubMed Articles
The origins of factitious disorder. Hist Human Sci 2010;23(2):68-85.
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation