CASE REPORT   

Minerva Psichiatrica 2005 December;46(4):325-31

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: Italian

A liaison psychiatry case: a factitious disorder

Munno D., Macario P. F., De Francesco A., Sterpone S. C. M.

In this paper we present the case of a 50-years old nun, impatient of a psychiatric ward for a factitious disorder. Patients suffering from factitious disorder feign or produce intentionally signs or symptoms of medical or psychic disease, to play the sick role. Writing down this case report, we lay out the clinical history of this patient, including meaningful life events and the complex and long medical course needed to get a conclusive diagnosis. Moreover, we report the intervention made during the hospitalisation in the psychiatric ward and the necessary setting of a therapeutic project, that has to overlap the limits of hospitalisation and to focus on a psychological-dynamic interention. This case puts on evidence the close link between psychiatric and medical ward, the complex dynamics underlying these straddling diseases and the complexity of the required intervention, paying attention also to medical-legal problems. The difficulty bound to the establishment of a therapeutic relationship, the compliance to pharmacotherapy and the influence of religious and cultural elements on the clinical-psychopathologic appearance are of great interest.