ADVERTISEMENTS:
Here is a compilation of essays on ‘Factitious Disorders’ for class 11 and 12. Find paragraphs, long and short essays on ‘Factitious Disorders’ especially written for school and college students.
Essay on Factitious Disorders
Essay Contents:
- Essay on Munchausen’s Syndrome
- Essay on Ganser’s Syndrome
- Essay on Malingering
- Essay on Compensation Neurosis
1. Essay on Munchausen’s Syndrome:
ADVERTISEMENTS:
Factitious disorders are characterized by the conscious, deliberate, and surreptitious feigning of physical or psychological symptoms to simulate disease. The only goal that is evident in such behaviour is the attainment of the role of the patient; this motivation is contrasted to malingering, in which a clear identifiable role is evident such as money, disability or relief from work.
History:
The term Munchausen’s syndrome was coined by Asher in 1951.
Other terms that have been applied to such patients have been “Peregrinating problem patients”, “Hospital hobos”, “Hospital addicts”, “Kopenickadus syndrome” and “Ahasuerus syndrome”.
ADVERTISEMENTS:
Epidemiology:
The exact prevalence of this disorder is not known. Onset is usually in early adult life often with a hospitalization for true physical illness.
Symptomatology:
All organ systems are potential targets, and the symptoms presented are limited only by the individual’s medical knowledge, sophistication and imagination. There may be uncontrollable pathological lying, in a manner intriguing to the listener about any aspect of the individual’s history or symptomatology (pseudologia fantastica).
Complaints for pain and requests for analgesics are very common. The patients often eagerly undergo multiple invasive procedures and operations and they have multiple scars on abdomen known as Grid iron Abdomen. When confronted with evidence of their factitious symptoms, they either deny the allegations or rapidly discharge themselves against medical advice.
The common predisposing factors include true physical disorder during childhood or adolescence leading to extensive medical treatment and hospitalization; a grudge against the medical profession, sometimes due to medical mismanagement, employment in the medical field as a nurse, technician or other paraprofessional; underlying dependent, exploitative or masochistic personality traits; an important relationship with a physician in the past.
Management:
A comprehensive evaluation of family and occupational situations is important. If initial confrontation does not result in denial or flight, a plan of psychotherapy can possibly be instituted and ideally should begin with inpatient psychiatric care.
2. Essay on Ganser’s Syndrome:
It is characterized by voluntary production of severe psychological (often psychotic) symptoms suggestive of mental disorder. This has also been referred to as Ganser Syndrome (named after a German psychiatrist in 1897), pseudopsychosis or pseudodementia.
The symptoms are worse when the individual is aware of being observed. Such a patient may complain of memory loss (recent and remote), hallucinations (auditory and visual), and dissociative and conversion symptoms along with suicidal ideation.
“Vorbeireden”, the symptom of giving approximate answers or talking past the point, may be present. When asked to multiply eight times eight, such a person may answer “sixty five”.
This is almost always superimposed on a severe personality disorder. The individual may secretly use substances for the purpose of producing symptoms that suggest nonorganic mental disorder, e.g., Stimulants; hallucinogens; analgesics.
This disorder is apparently more common in male and frequent hospitalizations are a complication.
A “pseudodementia” is differentiated from dementia that there are often near-miss, approximate answers rather than gross inability to answer questions correctly. In a true psychosis such as schizophrenia, the individual’s symptoms will persist but in factitious disorder, they may appear when patient is under the impression that he or she is being watched.
Management:
It is same as discussed above under “Factitious disorder with physical symptoms.”
3. Essay on Malingering:
It is defined by intentional production of physical or psychological symptoms motivated by identifiable “external incentives” (avoiding work or military obligation, obtaining financial compensation, evading criminal prosecution, obtaining drugs etc.). In contrast to factitious disorder, there should be an identifiable goal for behaviour other than that of securing the role or parenthood. (See Table 20.1).
A high index of suspicion of malingering should be aroused if any combination of the following is noted:
(i) Medicolegal context of presentation e.g., the person’s being referred by the court to the physician for examination.
(ii) Marked discrepancy between the person’s claimed distress or disability and the objective findings.
(iii) Lack of cooperation with the diagnostic evaluation and prescribed treatment regimen.
(iv) The presence of antisocial personality disorder. The detection of malingering is difficult, and each medical speciality has tended to develop its own set of guidelines for detection. Symptom relief in malingering is not often obtained by suggestions, hypnosis or intravenous barbiturates as it frequently is in conversion disorder.
4. Essay on Compensation Neurosis:
This refers to physical or mental symptoms which are caused psychologically in circumstances where the patient has made an unsettled claim for compensation. Symptoms persist as long as the claim continues or longer if compensation depends on regular review of the disability.
Any physical or psychiatric illness may be complicated by a superimposed compensation neurosis.
Failure to respond to conventional treatments, prolonged hospitalizations complaints out of proportion to documented pathology. Claims and litigations for benefits, and a constant preoccupation with disability are common features of this syndrome.