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EPA-1802 – Munchausen Syndrome - Comprehension of Factitial Dermatitis

Published online by Cambridge University Press:  15 April 2020

N. Almeida
Affiliation:
Alto Ave Hospital Center, Psychiatry and Mental Health Department, Guimarães, Portugal
H. Salgado
Affiliation:
Serviço de Saúde Mental e Comunitária de Matosinhos, Magalhães Lemos Hospital, Porto, Portugal
C. Ferreira
Affiliation:
Psychiatry and Mental Health Department, Braga Hospital, Braga, Portugal
P. Oliveira
Affiliation:
Serviço de Saúde Mental e Comunitário do Porto, Magalhães Lemos Hospital, Porto, Portugal

Abstract

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Introduction

Munchausen Syndrome (MS) is the most severe and chronic psychiatric disorder of factitious disorders. As a rule, external incentives are absent, being the core motivation the willingness to assume the sick role.

Objectives/Aims

Literature review on topic Munchausen Syndrome, with presentation of a clinical case.

Methods

Performed a literature review. Clinical data was collected in clinical process of the patient.

Results

The authors report a case of 47 years-old women, presenting marital and family stable relationship and good professional status, with MS. Was admitted to inpatient psychiatry unit in June 2013, by history of 177 episodes admissions at Dermatology and Surgery Departments, with 346 days of hospitalization, due to mixed panniculitis of infectious etiology with repeated abscesses, which started with a bite of a dog in the lower limb, 4 years before. In this period, was resistant to all treatments, only improving during hospitalizations. Medical conditions were excluded. During hospitalization showed depressive mood and refuted the self-inflicted nature of the injuries. Was referred for outpatient psychiatric unit, with the diagnosis of factitious dermatitis, medicated with venlafaxine 75 mg daily, Lorazepam and Flurazepam.

Conclusions

We highlight the case by dermatological repercussions and by psychodynamic myriad, given that the patient was raised by her grandparents after being abandoned by her mother at 20 months, which continues to avoid the rapprochement. As enshrined in the literature, the skin can be a vector for expression of certain psychosomatic unconscious conflicts and these in turn may have a cardinal role in the MPS.

Type
P06 - Consultation Liaison Psychiatry and Psychosomatics
Copyright
Copyright © European Psychiatric Association 2014
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