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Factitious disorder

A factitious disorder is a condition in which a person acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms. Factitious disorder by proxy is a condition in which a person deliberately produces, feigns, or exaggerates symptoms in a person in their care. Münchausen syndrome, a severe form of factitious disorder, was the first kind identified, and was for a period the umbrella term for all such disorders. People with this condition may produce symptoms by contaminating urine samples, taking hallucinogens, injecting themselves with bacteria to produce infections, and other similar behaviour. They might be motivated to perpetrate factitious disorders either as a patient or by proxy as a caregiver to gain any variety of benefits including attention, nurturance, sympathy, and leniency that are seen as not obtainable any other way. In contrast, somatoform disorders are characterised by multiple somatic complaints, albeit both are diagnoses of exclusion.

Source: Wikipedia

What are the symptoms?

Within all the people who go to their doctor with factitious disorder, 81% report having disturbance of memory, 72% report having depressive or psychotic symptoms, and 54% report having lip swelling. The symptoms that are highly suggestive of factitious disorder are disturbance of memory, depressive or psychotic symptoms, paresthesia, lip swelling, itchy eyelid, wrist weakness, excessive growth, elbow cramps or spasms, elbow weakness, and nailbiting, although you may still have factitious disorder without those symptoms.


What might my doctor prescribe?

Common Tests and Procedures

Patients with factitious disorder often receive mental health counseling, psychotherapy, psychological and psychiatric evaluation and therapy, echocardiography, blood alcohol, toxicology screen, hemoglobin a1c measurement and ultrasonography .

Common Medications

The most commonly prescribed drugs for patients with factitious disorder include clopidogrel (plavix), lorazepam, sirolimus, dapsone, ubiquinone (q10), raloxifene (evista), thiamine, donepezil (aricept), allopurinol, lamotrigine (lamictal), divalproex sodium (depakote), docusate (colace) and quetiapine (seroquel) .

Clopidogrel (Plavix)
$151
(28 days)
Lorazepam
$12
(28 days)
Sirolimus
$613
(28 days)
Dapsone
$40
(28 days)
Ubiquinone (Q10)

Raloxifene (Evista)
$105
(28 days)
Thiamine
$3
(28 days)
Donepezil (Aricept)
$210
(28 days)
Allopurinol
$4
(28 days)
Lamotrigine (Lamictal)
$63
(28 days)
Divalproex Sodium (Depakote)

Docusate (Colace)
$3
(21 days)
Quetiapine (Seroquel)
$290
(28 days)

Who is at risk?

Groups of people at highest risk for factitious disorder include age 60-74 years. On the other hand, race/ethnicity = black almost never get factitious disorder.

Age

< 1 years
0.2x
1-4 years
0.1x
5-14 years
0.1x
15-29 years
0.5x
30-44 years
0.6x
45-59 years
1.5x
60-74 years
2.8x
75+ years
1.1x

Sex

Male
0.7x
Female
1.2x

Race/Ethnicity

Black
0.0x
Hispanic
0.7x
White
1.5x
Other
0.1x
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