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Transtornos factícios

Last reviewed: 20 Aug 2025
Last updated: 31 Mar 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • história de queixas sem explicação ou inconsistência ao longo do tempo
  • manifestação incomum com relação aos dados demográficos
Full details

Other diagnostic factors

  • sintomas mais exagerados quando a pessoa sabe que está sendo observada
  • comparecer em diversos hospitais a fim de receber cuidados
  • evidência de testemunhas oculares que observaram o paciente manipulando os achados
  • história dramática de viagem e doença aguda (subtipo da síndrome de Munchausen)
  • várias cicatrizes abdominais (subtipo da síndrome de Munchausen)
  • medicamentos ou acessórios médicos encontrados em um local incomum no quarto do paciente
Full details

Risk factors

  • sexo feminino (transtorno factício)
  • emprego relacionado à área da saúde (transtorno factício)
  • características de personalidade do grupo B (transtorno factício)
  • sexo masculino (subtipo da síndrome de Munchausen)
  • estado civil solteiro (subtipo da síndrome de Munchausen)
  • idade de 40 a 50 anos (subtipo da síndrome de Munchausen)
  • traços de personalidade antissocial (subtipo da síndrome de Munchausen)
Full details

Diagnostic tests

1st tests to order

  • história clínica e exame físico
Full details

Tests to consider

  • culturas (por exemplo, hemocultura ou cultura da ferida)
  • peptídeo C sérico
  • sulfonilureias urinárias
  • eletrólitos na urina
  • proteína na urina
  • tireoglobulina sérica
Full details

Treatment algorithm

ACUTE

suspeita de transtorno factício

Contributors

Authors

James L. Levenson, MD

Professor of Psychiatry

Internal Medicine and Surgery

Vice-Chair

Department of Psychiatry

Chair

Division of Consultation/Liaison Psychiatry

Virginia Commonwealth University

Richmond

VA

Раскрытие информации

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

Выражение благодарностей

Prof Levenson would like to gratefully acknowledge Prof Christopher P. Kogut, a previous contributor to this topic.

Раскрытие информации

CPK declares that he has no competing interests.

Рецензенты

Tanveer Padder,

Consulting Psychiatrist

Padder Health Services

Laurel

MD

Раскрытие информации

TP declares that he has no competing interests.

Marc Feldman,

Clinical Professor of Psychiatry

University of Alabama

Tuscaloosa

AL

Раскрытие информации

MF receives royalties for two books on the subjects covered in this topic (Routledge publishing and American Psychiatric Publishing). He is also an author of references cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022.

Asher R. Munchausen's syndrome. Lancet. 1951 Feb 10;1(6650):339-41. Аннотация

Ford CV, Sonnier L, & McCullumsmith C. Chapter 12: Deception syndromes. In: Levenson JL, ed. The American Psychiatric Association Publishing Textbook of psychosomatic medicine and consultation-liaison psychiatry. 3rd ed. Washington, DC: American Psychiatric Association; 2018.

Sutherland AJ, Rodin GM. Factitious disorders in a general hospital setting: clinical features and a review of the literature. Psychosomatics. 1990 Fall;31(4):392-9. Аннотация

Статьи, указанные как источники

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