Behavioral Health

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"The individual who fabricates physical or psychological symptoms is often a diagnostic challenge for even a highly astute clinician.\n\nFalling prey to a well staged deception may result in misdiagnosis - or even worse, fruitless interventions and investigations, which then convert the pretender into a person with an iatrogenically induced medical condition.\n\nConsider this 22 year old woman; she has presented with a textbook history of cluster headaches, but has not shown any response to medications; in addition, her investigations have all been unremarkable, while her previous care provider was suspicious that her signs and symptoms were artificially fabricated.\n\nThus, there is high suspicion that this may be a psychiatric disease - either malingering, somatization disorder, or factitious disorder.\n\nWhile she complains of a severe headache, note that she does not demonstrate a commensurate degree of agony; this makes somatisation disorder unlikely, as these patients genuinely experienc"}]}

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