Factitious disorder imposed on self: A retrospective study of 2232 cases from health insurance databases

Insulin Abuse: A Case Report of Munchausen Syndrome

Hypoglycaemia in individuals with diabetes is defined as the presence of signs or symptoms in addition to potentially occurring abnormal plasma glucose levels in the patient. Munchausen Syndrome (MS) is characterized by the deliberate induction of physical or psychological symptoms or the act of pretending to have symptoms. Patient reports of this factitious disease pattern are limited in the literature. The diagnosis and treatment of this syndrome, which is among factitious disorders, is very difficult. Endocrinological complaints are very common among those admitted to the hospitals.

BACKGROUND

Unnecessary and numerous examinations cause financial losses and loss of time for both the individual and the healthcare system. In this case report, we aimed to discuss the management of a patient who tried to gain secondary gain by creating artificial hypoglycemia attacks.

CASE REPORT

In this case report, the diagnosis of Munchausen syndrome given to a 28-year-old female patient who was diagnosed with type I diabetes and repeatedly admitted to the hospital due to hypoglycemia attacks is discussed.

CONCLUSION

Munchausen syndrome is an important and often overlooked diagnosis that should be kept in mind due to the possibility of individuals harming themselves unpredictably, as well as causing disruptions in the healthcare system and wasting time due to numerous and unnecessary examinations and evaluations. For this reason, it is a diagnosis that should be kept in mind in cases of unexplained hypoglycemia attacks.

[Factitious disorder imposed on self and Munchausen syndrome: An update]

Factitious disorder imposed on self (FDIS) is a mental disorder characterized by conscious manipulative behavior from patients with no clearly identifiable external objective. It affects subjects with a wide range of characteristics, only some of whom fit the stereotypical profile of the young female working in the health sector. It can take the form of a variety of symptoms or clinical signs, and is likely to involve all specialties. Munchausen syndrome is a particular form of FDIS, more prevalent in men and marked by its severity. Psychiatric comorbidities are common in patients with FDIS. Death is rare but possible, either as a result of the disease itself, complications of examinations or treatments, or suicide. The diagnostic approach must seek to identify positive arguments in favor of the disorder. Diagnosis by elimination remains possible when no other hypothesis can explain a clinical picture suggestive of FDIS. The prognosis is often poor, at least in the short and medium term. Avoiding unnecessary prescriptions is essential to prevent iatrogenesis. The management of FDIS is poorly codified. In all cases, the practitioner must adopt a non-aggressive, empathetic attitude.