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
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
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)
Diagnostic tests
1st tests to order
- história clínica e exame físico
Tests to consider
- culturas (por exemplo, hemocultura ou cultura da ferida)
- peptídeo C sérico
- sulfonilureias urinárias
- eletrólitos na urina
- proteína na urina
- tireoglobulina sérica
Treatment algorithm
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
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
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Simulação
- Sintomas somáticos e transtornos relacionados
- Doença orgânica
Больше ОтличияРекомендации
- Perplexing presentations (PP)/fabricated or induced illness (FII) in children - guidance
- Assessment and management of adults and children in cases of fabricated or induced illness
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