Login Register Cart 0
Generic placeholder image

Current Psychiatry Research and Reviews

Editor-in-Chief

ISSN (Print): 2666-0822
ISSN (Online): 2666-0830

Back
Journal Home About Journal Editorial Board Current Issue Volumes/Issues
Subscribe
Case Report

Feigning Capgras Syndrome and Developmental Prosopagnosia: A Rare Case of Pediatric Factitious Disorder

Author(s): Giulia Antolini, Elena Puttini, Riccardo Bortoletto, Carolina Begnini, Leonardo Zoccante and Marco Colizzi*

Volume 19, Issue 2, 2023

Published on: 12 September, 2022

Page: [201 - 212] Pages: 12

DOI: 10.2174/2666082218666220822163152

Price: $65

conference banner
Abstract

Background: Factitious Disorder is a condition included among psychiatric disorders, where symptoms are intentionally produced to seek medical attention. Its epidemiology, treatment, and outcome are largely unknown.

Objective: To increase knowledge of the condition, we discuss a pediatric case where the patient feigned neuropsychiatric symptoms.

Methods: A 15-year-old female adolescent presented with neuropsychiatric symptoms suggestive of rare conditions such as Delusional Misidentification Syndrome (i.e., Capgras and Fregoli syndromes) and Developmental Prosopagnosia as well as epileptic seizures.

Results: When Delusional Misidentification Syndrome was suspected, she was treated with Risperidone. Due to suboptimal response, Alprazolam and Sertraline were added and then Risperidone was cross-titrated to Haloperidol. The condition severity led to her admission to an inpatient Child and Adolescent Neuropsychiatry Unit. MRI scan and electroencephalographic recording were normal. The self- and parent-reported psychological assessment indicated several psychiatric symptoms. Instead, the clinician-administered Minnesota Multiphasic Personality Inventory-Adolescent and Structured Inventory of Malingered Symptomatology suggested a fake-bad profile and neuropsychiatric symptom simulation. Along with evidence of incongruent symptoms between the patient’s interviews, such investigations led to the diagnosis of Factitious Disorder. Psychopharmacological treatment was discontinued, and psychological support was offered to the patient and her parents.

Conclusion: Increasing knowledge about Factitious Disorder is needed.

Keywords: Munchausen syndrome, malingering, confrontation, psychopharmacology, psychotherapy, child and adolescent neuropsychiatry, intelligence.

« Previous
Graphical Abstract

[1]
Asher R. Munchausen’s syndrome. Lancet 1951; 1(6650): 339-41.
[http://dx.doi.org/10.1016/S0140-6736(51)92313-6] [PMID: 14805062]
[2]
APA. Diagnostic and statistical manual of mental disorders. (5th ed.), Arlington, TX, USA: American Psychiatric Publishing 2013.
[3]
World Health Organization. ICD-11: International classification of diseases (11th revision). 2019. Available from: https://icd.who.int/
[4]
Hamilton JC, Feldman MD, Janata JW. The A, B, C’s of factitious disorder: A response to Turner. Medscape J Med 2009; 11(1): 27.
[PMID: 19295948]
[5]
Bass C, Halligan P. Factitious disorders and malingering: Challenges for clinical assessment and management. Lancet 2014; 383(9926): 1422-32.
[http://dx.doi.org/10.1016/S0140-6736(13)62186-8] [PMID: 24612861]
[6]
Ruppert R, Jeremy Mao KH. The girl who cried wolf: A literature review and case report of pediatric factitious disorder. Clin Child Psychol Psychiatry 2021; 26(3): 695-705.
[http://dx.doi.org/10.1177/1359104521996742] [PMID: 33624517]
[7]
Mousailidis G, Lazzari C, Bhan-Kotwal S, Papanna B, Shoka A. Factitious disorder: A case report and literature review of treatment. Prog Neurol Psychiatry 2019; 23(2): 14-8.
[http://dx.doi.org/10.1002/pnp.533]
[8]
Ford CV. Deception syndromes: Factitious disorders and malingering. In: Levenson JL, Ed. The American Psychiatric Publishing textbook of psychsomatic medicine Psychiatric care of the medically ill. (2nd ed.291.),
[9]
Huffman JC, Stern TA. The diagnosis and treatment of Munchausen’s syndrome. Gen Hosp Psychiatry 2003; 25(5): 358-63.
[http://dx.doi.org/10.1016/S0163-8343(03)00061-6] [PMID: 12972228]
[10]
Lawlor A, Kirakowski J. When the lie is the truth: Grounded theory analysis of an online support group for factitious disorder. Psychiatry Res 2014; 218(1-2): 209-18.
[http://dx.doi.org/10.1016/j.psychres.2014.03.034] [PMID: 24745468]
[11]
Yates GP, Feldman MD. Factitious disorder: A systematic review of 455 cases in the professional literature. Gen Hosp Psychiatry 2016; 41: 20-8.
[http://dx.doi.org/10.1016/j.genhosppsych.2016.05.002] [PMID: 27302720]
[12]
Krahn LE, Li H, O’Connor MK. Patients who strive to be ill: Factitious disorder with physical symptoms. Am J Psychiatry 2003; 160(6): 1163-8.
[http://dx.doi.org/10.1176/appi.ajp.160.6.1163] [PMID: 12777276]
[13]
Burton MC, Warren MB, Lapid MI, Bostwick JM. Munchausen syndrome by adult proxy: A review of the literature. J Hosp Med 2015; 10(1): 32-5.
[http://dx.doi.org/10.1002/jhm.2268] [PMID: 25274180]
[14]
Di Lorenzo R, Lannocca L, Burattini M, et al. Early death in Munchausen syndrome: A case report. Clin Case Rep 2019; 7(8): 1473-7.
[http://dx.doi.org/10.1002/ccr3.2254] [PMID: 31428370]
[15]
Caselli I, Poloni N, Ielmini M, Diurni M, Callegari C. Epidemiology and evolution of the diagnostic classification of factitious disorders in DSM-5. Psychol Res Behav Manag 2017; 10: 387-94.
[http://dx.doi.org/10.2147/PRBM.S153377] [PMID: 29270035]
[16]
Reich P, Gottfried LA. Factitious disorders in a teaching hospital. Ann Intern Med 1983; 99(2): 240-7.
[http://dx.doi.org/10.7326/0003-4819-99-2-240] [PMID: 6881779]
[17]
Sutherland AJ, Rodin GM. Factitious disorders in a general hospital setting: Clinical features and a review of the literature. Psychosomatics 1990; 31(4): 392-9.
[http://dx.doi.org/10.1016/S0033-3182(90)72133-0] [PMID: 2247566]
[18]
Carney MW, Brown JP. Clinical features and motives among 42 artifactual illness patients. Br J Med Psychol 1983; 56(Pt 1): 57-66.
[http://dx.doi.org/10.1111/j.2044-8341.1983.tb01532.x] [PMID: 6838782]
[19]
O’Reilly RA, Aggeler PM. Covert anticoagulant ingestion: Study of 25 patients and review of world literature. Medicine (Baltimore) 1976; 55(5): 389-99.
[http://dx.doi.org/10.1097/00005792-197609000-00003] [PMID: 957998]
[20]
Petersdorf RG, Beeson PB. Fever of unexplained origin: Report on 100 cases. Medicine (Baltimore) 1961; 40: 1-30.
[http://dx.doi.org/10.1097/00005792-196102000-00001] [PMID: 13734791]
[21]
Maurice-Williams RS, Marsh H. Simulated paraplegia: An occasional problem for the neurosurgeon. J Neurol Neurosurg Psychiatry 1985; 48(8): 826-31.
[http://dx.doi.org/10.1136/jnnp.48.8.826] [PMID: 4031935]
[22]
Grunberger G, Weiner JL, Silverman R, Taylor S, Gorden P. Factitious hypoglycemia due to surreptitious administration of insulin. Diagnosis, treatment, and long-term follow-up. Ann Intern Med 1988; 108(2): 252-7.
[http://dx.doi.org/10.7326/0003-4819-108-2-252] [PMID: 3277509]
[23]
Plassmann R. Inpatient and outpatient long-term psychotherapy of patients suffering from factitious disorders. Psychother Psychosom 1994; 62(1-2): 96-107.
[http://dx.doi.org/10.1159/000288910] [PMID: 7984774]
[24]
Freyberger H, Nordmeyer JP, Freyberger HJ, Nordmeyer J. Patients suffering from factitious disorders in the clinico-psychosomatic consultation liaison service: Psychodynamic processes, psychotherapeutic initial care and clinicointerdisciplinary cooperation. Psychother Psychosom 1994; 62(1-2): 108-22.
[http://dx.doi.org/10.1159/000288911] [PMID: 7984759]
[25]
Shapiro AP, Teasell RW. Strategic-behavioural intervention in the inpatient rehabilitation of non-organic (factitious/conversion) motor disorders. NeuroRehabilitation 1997; 8(3): 183-92.
[http://dx.doi.org/10.3233/NRE-1997-8305] [PMID: 24526047]
[26]
Al-Qattan MM. Factitious disorders of the upper limb in Saudi Arabia. J Hand Surg [Br] 2001; 26(5): 414-21.
[http://dx.doi.org/10.1054/jhsb.2000.0503] [PMID: 11560421]
[27]
Eisendrath SJ, McNiel DE. Factitious disorders in civil litigation: Twenty cases illustrating the spectrum of abnormal illness-affirming behavior. J Am Acad Psychiatry Law 2002; 30(3): 391-9.
[http://dx.doi.org/10.1016/j.genhosppsych.2016.05.002] [PMID: 12380419]
[28]
Gregory RJ, Jindal S. Factitious disorder on an inpatient psychiatry ward. Am J Orthopsychiatry 2006; 76(1): 31-6.
[http://dx.doi.org/10.1037/0002-9432.76.1.31] [PMID: 16569124]
[29]
Aadil M, Faraz A, Anwar MJ, Shoaib M, Nasir U, Akhlaq A. A case of Munchausen syndrome presenting with Hematemesis: A case report. Cureus 2017; 9(6): e1348.
[http://dx.doi.org/10.7759/cureus.1348] [PMID: 28979830]
[30]
Ameratunga R, Casey P, Parry S, Kenedi C. Hypogammaglobulinemia factitia- Munchausen syndrome masquerading as common variable immune deficiency. Allergy Asthma Clin Immunol 2013; 9(1): 36.
[http://dx.doi.org/10.1186/1710-1492-9-36] [PMID: 24341706]
[31]
Vaduganathan M, McCullough SA, Fraser TN, Stern TA. Death due to munchausen syndrome: A case of idiopathic recurrent right ventricular failure and a review of the literature. Psychosomatics 2014; 55(6): 668-72.
[http://dx.doi.org/10.1016/j.psym.2014.05.013] [PMID: 25262044]
[32]
Sousa Filho D, Kanomata EY, Feldman RJ, Maluf Neto A. Munchausen syndrome and Munchausen syndrome by proxy: A narrative review. Einstein (Sao Paulo) 2017; 15(4): 516-21.
[http://dx.doi.org/10.1590/s1679-45082017md3746] [PMID: 29364370]
[33]
Eastwood S, Bisson JI. Management of factitious disorders: A systematic review. Psychother Psychosom 2008; 77(4): 209-18.
[http://dx.doi.org/10.1159/000126072] [PMID: 18418027]
[34]
Bérar A, Bouzillé G, Jego P, Allain JS. A descriptive, retrospective case series of patients with factitious disorder imposed on self. BMC Psychiatry 2021; 21(1): 588.
[http://dx.doi.org/10.1186/s12888-021-03582-8] [PMID: 34814866]
[35]
Ventriglio A, Bhugra D, De Berardis D, Torales J, Castaldelli-Maia JM, Fiorillo A. Capgras and Fregoli syndromes: Delusion and misidentification. Int Rev Psychiatry 2020; 32(5-6): 391-5.
[http://dx.doi.org/10.1080/09540261.2020.1756625] [PMID: 32378427]
[36]
Achenbach TM. Manual for the Youth Self-Report and 1991 profile. Burlington: Department of Psychiatry, University of Vermont 1991.
[37]
Cianchetti C, Sannio Fascello G. Scale Psichiatriche di Autosomministrazione per Fanciulli e Adolescenti (SAFA). Organizzazioni Speciali 2001.
[38]
Achenbach TM, Rescorla LA. Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT, USA: University of Vermont Research Center for Children, Youth & Families 2001.
[39]
Albonico A, Barton J. Progress in perceptual research: The case of prosopagnosia. F1000 Res 2019; 8: 765.
[http://dx.doi.org/10.12688/f1000research.18492.1] [PMID: 31231507]
[40]
Wechsler D. The Wechsler Intelligence Scale for Children. (4th ed.), Washington, DC, USA: APA PsycNet 2003.
[41]
Smith GP, Burger GK. Detection of malingering: Validation of the Structured Inventory of Malingered Symptomatology (SIMS). J Am Acad Psychiatry Law 1997; 25(2): 183-9.
[PMID: 9213290]
[42]
Butcher JN, Williams CL, Graham JR, Archer RP, Tellegen A, Ben-Porath YS, et al. MMPI-A (Minnesota Multiphasic Personality Inventory–Adolescent): Manual for administration, scoring, and interpretation. (Rev. ed..), Minneapolis: University of Minnesota Press 1992.
[43]
Archer RP, Gordon RA, Kirchner FH. MMPI response-set characteristics among adolescents. J Pers Assess 1987; 51(4): 506-16.
[http://dx.doi.org/10.1207/s15327752jpa5104_2] [PMID: 3681637]
[44]
Stein LA, Graham JR, Williams CL. Detecting fake-bad MMPI-A profiles. J Pers Assess 1995; 65(3): 415-27.
[http://dx.doi.org/10.1207/s15327752jpa6503_3] [PMID: 16367708]
[45]
Lucio E, Durán C, Graham JR, Ben-Porath YS. Identifying faking bad on the Minnesota Multiphasic Personality Inventory-Adolescent with Mexican adolescents. Assessment 2002; 9(1): 62-9.
[http://dx.doi.org/10.1177/1073191102009001008] [PMID: 11911236]
[46]
Stein LAR, McClinton BK, Graham JR. Long-term stability of MMPI-A scales. J Pers Assess 1998; 70(1): 103-8.
[http://dx.doi.org/10.1207/s15327752jpa7001_7] [PMID: 9615426]
[47]
Monaro M, Toncini A, Ferracuti S, et al. The detection of Malingering: A new tool to identify made-up depression. Front Psychiatry 2018; 9(JUN): 249.
[http://dx.doi.org/10.3389/fpsyt.2018.00249] [PMID: 29937740]
[48]
Catalina ML, Gómez Macias V, de Cos A. Prevalence of factitious disorder with psychological symptoms in hospitalized patients. Actas Esp Psiquiatr 2008; 36(6): 345-9.
[PMID: 18568455]
[49]
Adetunji BA, Basil B, Mathews M, Williams A, Osinowo T, Oladinni O. Detection and management of malingering in a clinical setting. Prim Psychiatry 2006; 13(1): 61-9.
[50]
Ferrara SD, Ananian V, Baccino E, et al. A novel methodology for the objective ascertainment of psychic and existential damage. Int J Legal Med 2016; 130(5): 1387-99.
[http://dx.doi.org/10.1007/s00414-016-1366-8] [PMID: 27147416]
[51]
Prior TI, Gordon A. Treatment of factitious disorder with pimozide. Can J Psychiatry 1997; 42(5): 532.
[http://dx.doi.org/10.1177/070674379704200521] [PMID: 9220122]
[52]
Fehnel CR, Brewer EJ. Munchausen’s syndrome with 20-year follow-up. Am J Psychiatry 2006; 163(3): 547.
[http://dx.doi.org/10.1176/appi.ajp.163.3.547-a] [PMID: 16513885]
[53]
David D, Marc D, Feldman MD. Somatoform disorders, factitious disorders and malingering. In: Fogel BS, Greenberg DB, Eds. Psychiatric Care of the Medical Patient. (2nd ed.). Oxford University Press 1993; pp. 470-2.
[54]
Stone MH. Factitious illness. Psychological findings and treatment recommendations. Bull Menninger Clin 1977; 41(3): 239-54.
[PMID: 871556]
[55]
Eisendrath SJ. Factitious physical disorders: Treatment without confrontation. Psychosomatics 1989; 30(4): 383-7.
[http://dx.doi.org/10.1016/S0033-3182(89)72243-X] [PMID: 2798730]

Rights & Permissions Print Cite
Article Metrics
5
© 2024 Bentham Science Publishers | Privacy Policy