Factitious Disorders, Malingering and Criminality MCQs

CLUES THAT SHOULD TRIGGER SUSPICION OF FACTITIOUS DISORDER: Unusual, dramatic presentation of symptoms that defy conventional medical or psychiatric understanding (Option A) Symptoms do not respond appropriately to usual treatment or medications Emergence of new, unusual symptoms when other symptoms resolve (Option B) Eagerness to undergo procedures or testing or to recount symptoms (Option C) Reluctance to give access to collateral sources of information (i.e., refusing to sign releases of information or to give contact information for family and friends) Extensive medical history or evidence of multiple surgeries Multiple drug allergies Medical profession (Option D) Few visitors Ability to forecast unusual progression of symptoms or unusual response to treatment Reference: Kaplan and Sadock’s Synopsis of Psychiatry, Eleventh edition, Chapter 13.6, Factitious Disorder, Page 490

METHODS OF SIMULATION OF FEVER IN FACTITIOUS DISORDER: Warming thermometer against a lightbulb or other heat source Drinking hot fluids Friction from mouth or anal sphincter False recordings Injection of pyrogens such as faeces, vaccines, thyroid hormone, or tetanus toxoid POSSIBLE METHODS OF DETECTION OF FALSIFIED HISTORY OF FEVER GIVEN IN FACTITIOUS DISORDER: Simultaneous taking of temperature from two different locals (orally and rectally )- (Option A) Recording the temperature of freshly voided urine (Option B) The appearance of cool skin despite high thermometer readings Normal white blood cell count (Option D) Unusually high or inconsistent temperatures Reference: Kaplan and Sadock’s Synopsis of Psychiatry, Eleventh edition, Chapter 13.6, Factitious Disorder, Page 494