Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • hx of unexplained complaints or inconsistency over time
  • unusual presentation relative to demographics

Other diagnostic factors

  • symptoms more exaggerated while aware of being observed
  • presentation for care at many different hospitals
  • eyewitness evidence of the patient manipulating findings
  • dramatic hx of travel and acute illness (Munchausen subtype)
  • multiple abdominal scars (Munchausen subtype)
  • medications or medical paraphernalia found in an unusual location in a patient's room

Risk factors

  • female gender (common-variety factitious disorder)
  • medically related employment (common-variety factitious disorder)
  • cluster B personality characteristics (common-variety factitious disorder)
  • male gender (Munchausen subtype)
  • single marital status (Munchausen subtype)
  • age 40 to 50 years (Munchausen subtype)
  • antisocial personality traits (Munchausen subtype)

Diagnostic investigations

1st investigations to order

  • clinical hx and examination
Full details

Investigations to consider

  • cultures (e.g., blood or wound)
  • serum C-peptide
  • urine sulphonylureas
  • urine electrolytes
  • urine protein
  • serum thyroglobulin
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Christopher P. Kogut

Assistant Professor

Department of Psychiatry

Virginia Commonwealth University

Richmond

VA

Disclosures

CPK declares that he has no competing interests.

Professor of Psychiatry

Internal Medicine and Surgery

Vice-Chair

Department of Psychiatry

Chair

Division of Consultation/Liaison Psychiatry

Virginia Commonwealth University

Richmond

VA

Disclosures

JLL is the author of a reference cited in this monograph.

Peer reviewers VIEW ALL

Professor

Department of Psychiatry

University of New Mexico School of Medicine

Albuquerque

NM

Disclosures

JY is an author of a reference cited in this monograph.

Consultant Psychiatrist

The London Medical Centre

London

UK

Disclosures

AR declares that she has no competing interests.

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