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Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report
BACKGROUND: There is a high prevalence of somatoform disorders and medically unexplained symptoms. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder. The case presented demonstrates the impact on disability...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416532/ https://www.ncbi.nlm.nih.gov/pubmed/37563729 http://dx.doi.org/10.1186/s13256-023-04063-0 |
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author | Pozuelo Moyano, Beatriz Duquenne, Catherine Favrat, Bernard Francois-Xavier, Borruat Kokkinakis, Ioannis Tzartzas, Konstantinos |
author_facet | Pozuelo Moyano, Beatriz Duquenne, Catherine Favrat, Bernard Francois-Xavier, Borruat Kokkinakis, Ioannis Tzartzas, Konstantinos |
author_sort | Pozuelo Moyano, Beatriz |
collection | PubMed |
description | BACKGROUND: There is a high prevalence of somatoform disorders and medically unexplained symptoms. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder. The case presented demonstrates the impact on disability benefits and the subsequent psychosocial repercussions of misdiagnosing between a factitious disorder and a somatoform disorder. CASE PRESENTATION: A 42-year-old Caucasian woman worked as a 100% fiduciary accountant until the age of 32 when she was placed on medical leave due to persistent trigeminal neuralgia. Afterward, she developed total blindness, not explained by a physiological process, accompanied by distress in a crucial emotional context. We evaluated the patient for a revision of a disability income after a diagnosis of factitious disorder with severe consequences such as disability income suspension and family conflict. Our psychiatric examination concluded the diagnoses of pain disorders related to psychological factors and a dissociative neurological symptom disorder with visual disturbance. CONCLUSIONS: Blindness not explained by a physiological process may accompany trauma and psychological distress. Differentiating this pathology from factitious disorder or simulation is essential from an insurance medicine point of view, but also for its treatment. |
format | Online Article Text |
id | pubmed-10416532 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-104165322023-08-12 Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report Pozuelo Moyano, Beatriz Duquenne, Catherine Favrat, Bernard Francois-Xavier, Borruat Kokkinakis, Ioannis Tzartzas, Konstantinos J Med Case Rep Case Report BACKGROUND: There is a high prevalence of somatoform disorders and medically unexplained symptoms. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder. The case presented demonstrates the impact on disability benefits and the subsequent psychosocial repercussions of misdiagnosing between a factitious disorder and a somatoform disorder. CASE PRESENTATION: A 42-year-old Caucasian woman worked as a 100% fiduciary accountant until the age of 32 when she was placed on medical leave due to persistent trigeminal neuralgia. Afterward, she developed total blindness, not explained by a physiological process, accompanied by distress in a crucial emotional context. We evaluated the patient for a revision of a disability income after a diagnosis of factitious disorder with severe consequences such as disability income suspension and family conflict. Our psychiatric examination concluded the diagnoses of pain disorders related to psychological factors and a dissociative neurological symptom disorder with visual disturbance. CONCLUSIONS: Blindness not explained by a physiological process may accompany trauma and psychological distress. Differentiating this pathology from factitious disorder or simulation is essential from an insurance medicine point of view, but also for its treatment. BioMed Central 2023-08-11 /pmc/articles/PMC10416532/ /pubmed/37563729 http://dx.doi.org/10.1186/s13256-023-04063-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Pozuelo Moyano, Beatriz Duquenne, Catherine Favrat, Bernard Francois-Xavier, Borruat Kokkinakis, Ioannis Tzartzas, Konstantinos Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report |
title | Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report |
title_full | Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report |
title_fullStr | Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report |
title_full_unstemmed | Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report |
title_short | Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report |
title_sort | clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416532/ https://www.ncbi.nlm.nih.gov/pubmed/37563729 http://dx.doi.org/10.1186/s13256-023-04063-0 |
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