Factitious Disorder / Munchausen Syndrome

Question 1

Pseudologia phantastica

Answer 1

Telling of “tall tales”, or lying, commonly seen in factitious disorder

Question 2

Who tends to develop Munchausen syndrome?

Answer 2

Patients with average to above-average intelligence, poor self-identity, and strong dependency needs

Often there is a history of childhood mistreatment (physical, sexual, emotional abuse).

A significant number of these patients also meet criteria for Borderline Personality Disorder

Question 3

Treatment of factitious disorders

Answer 3

There is no treatment, per se. These inviduals are also extremely resistant to engaging with mental health care.

If there are underlying disorders such as depression and anxiety, these should be treated as indicated.

Question 4

While not a criterion for Factitious disorder, often the motivation is . . .

Answer 4

. . . to take on the sick role.

However, in many cases no clear internal motivation is identified, and it may be unconscious to the patient.

Question 5

__ is the single most important thing in addressing Factitious disorders

Answer 5

Establishing a strong therapeutic alliance is the single most important thing in addressing Factitious disorders

Question 6

Best initial step if you think that a patient is malingering

Answer 6

Gather collateral history!!!

Question 7

Projective Identification

Answer 7

A defense mechanism in which individuals deal with emotional conflict or stressors by falsely attributing to anothe person their own unacceptable feelings, impulses, or thoughts

Question 8

Primary vs Secondary gain

Answer 8

Primary gain: Relief of tension or conflict through neurotic illness

Secondary gain: Obvious advantage that a person gains from an illness, such as gifts, attention, or release from responsibility