Psychiatry and Behavioral Health Rotation

A condition in which a person, without a motive for reward, acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms, purely to attain (for themselves or for another) a patient's role.

Factitious disorder imposed on self (Munchausen syndrome)

• The patient falsifies physical or psychological symptoms or induces injury or disease to themselves
• When in another person (e.g., a child) it is termed factitious disorder imposed on another (Munchausen syndrome by proxy)

Treatment:

• Conjoint confrontation by the PCP and the psychiatrist
• In factitious disorder imposed on another (e.g., in a child)
  • Children must be removed by child protective services

• Patient's are worried about having or developing a serious illness and
• This preoccupation is present for at least 6 months and
• Is not better explained by another mental disorder (e.g., obsessive-compulsive disorder and somatic symptom disorder)

Treatment:

• Group/insight-oriented therapy
• Regular appts with a provider for reassurance
• Medications: (SSRIs) if concurrent/underlying anxiety or major depressive disorder

• More than 1 somatic symptom(s) which are distressing to the patient or leads to a significant amount of disruption in the patient's life.
• The patient experiences excessive thoughts, feelings, and behaviors in relation to their somatic symptoms or their health concerns.
• The somatic symptom must be persistent for ≥ 6 months although these symptoms don't have to always be present

Treatment

• Have a single clinician as the designated primary caretaker
  • Schedule monthly visits and psychotherapy
  • Avoid unnecessary diagnostic testing unless indicated