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4 results

  • Chapter 6.6 - Bodily Distress Disorder, Chronic Pain and Factitious Disorders

  • Edited by David Kingdon, University of Southampton, Paul Rowlands, Derbyshire Healthcare NHS foundation Trust, George Stein, Emeritus of the Princess Royal University Hospital
  • Book:
    Seminars in General Adult Psychiatry
    Published online:
    04 April 2024
    Print publication:
    18 April 2024, pp 387-403

  • Summary

    Patients with bodily distress, hypochondriasis and chronic pain experience symptoms that impair their functioning and cause them significant degrees of discomfort. They also represent a significant public health challenge. Problems in classification/nosology continue to bedevil this area, and these difficulties – along with the use of the language of psychiatric classification, which most patients find unacceptable – continue to led to the DSM/ICD terms being little used in day-to-day clinical practice, including liaison psychiatry. Biological, psychological and social factors are relevant to both the aetiology and the maintenance of these syndromes, as well as to their treatment. In recent years, a variety of effective biological and psychosocial approaches to treatment have been developed, and these patients can now be considered as a group for whom medical and psychological approaches should be offered.

  • Munchausen syndrome by proxy presenting as hearing loss

  • N Ashraf, M S Thevasagayam
  • Journal:
    The Journal of Laryngology & Otology / Volume 128 / Issue 6 / June 2014
    Published online by Cambridge University Press:
    22 May 2014, pp. 540-542
    Print publication:
    June 2014
  • Objective:

    To review the diagnosis of Munchausen syndrome by proxy, a factitious disorder, in which symptoms are induced or feigned, usually in a child, by the caregiver. The involved caregiver seeks to gain attention or sympathy and often has a psychological need to maintain the sick role. We highlight the diagnostic difficulties and factors that may help with diagnosis in an otolaryngology setting.

    Method:

    We present the case of Munchausen syndrome by proxy presenting with hearing loss in a five-year old boy, who was diagnosed eight years after his initial presentation. A literature review of Munchausen syndrome by proxy cases presenting with ENT symptoms is provided.

    Conclusion:

    Munchausen syndrome by proxy is a diagnosis that otolaryngologists should be aware of, particularly where recurrent or persistent illnesses in children, especially those involving otological symptoms, are refractory to the usual treatments.