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CRACKCast & Physicians as Humans on CanadiEM

CanadiEM aims to improve emergency care in Canada by building an online community of practice for healthcare practitioners and providing them with high quality, freely available educational resources. The CanadiEM Podcast brings you cutting edge clinical topics on the National Rounds Series and delves into the struggles that doctors face on the Physicians as Humans Series.

Oct 2, 2017

This episode of CRACKCast covers Rosen' 9th edition, Chapter 104, Factitious Disorders and Malingering.

Episode Overview

  • Two categories of psychiatric illness are covered in this episode
    • Factitious Disorder
    • Malingering
  • Individuals suffering from factitious disorders fabricate symptoms of illness to fulfill the sick role (primary gain)
  • Individuals suffering from malingering fabricate symptoms of illness to obtain something (secondary gain)
  • Despite the fact that we may suspect either factitious disorder or malingering, we must strive to objectively assess the patient for concrete evidence of disease
  • If no objective evidence of disease exists in a patient, do not investigate with needless and/or harmful diagnostic modalities
    • Refer back to their primary care physician
  • If you are suspecting factitious disorder by proxy, the safety of your patient should always be your first priority 

Core Questions

  • What is a factitious disorder and what is malingering?
  • List the DSM-5 diagnostic criteria for factitious disorder imposed on self (FDIS)
  • List the DSM-5 diagnostic criteria for factitious disorder imposed on another (FDIA)
  • List four characteristics of malingering