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Classification system for factitious syndromes in the hand with implications for treatment. J Hand Surg Am 1991 Nov;16(6):1027-30

Date

11/01/1991

Pubmed ID

1748746

DOI

10.1016/s0363-5023(10)80062-0

Scopus ID

2-s2.0-0026356198   32 Citations

Abstract

We evaluated 29 patients with factitious disorders in the hand who received Worker's Compensation benefits. Three types of factitious hand disorders based on physical presentation were self-mutilation and wound manipulation, edema, and finger and hand deformities. Two distinct psychological diagnoses present were factitious disorder with physical symptoms and conversion disorder. The Minnesota Multiphasic Personality Inventory revealed two personality profiles: emotionally dependent and angry and hostile. Behavioral treatment was implemented. The emotionally dependent group responded well, with 80% returning to work. The angry and hostile group had a much poorer response, with 21% returning to work. None of the self-multilating patients returned to work. We recommend a combined evaluation by a physician, a psychologist, and a hand therapist to achieve a definitive diagnosis for these disorders. The identification of psychological profiles assists in ascertaining which patients will be responsive to behavioral treatment.

Author List

Grunert BK, Sanger JR, Matloub HS, Yousif NJ

Authors

Brad K. Grunert PhD Professor in the Plastic Surgery department at Medical College of Wisconsin
Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of Wisconsin
James R. Sanger MD Professor in the Plastic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Accidents, Occupational
Edema
Factitious Disorders
Female
Hand Deformities, Acquired
Hand Injuries
Humans
MMPI
Male
Personality