Complex Regional Pain Syndrome and Factitious Disorders-Factitious Hand Disorders: Review of 29 Years of Multidisciplinary Care

Factitious Hand Disorders: Review of 29 Years of Multidisciplinary Care

Pdf Summary

Factitious hand disorders are self-inflicted injuries or conditions that are intentionally caused or fabricated by individuals. They pose a diagnostic challenge and can result in significant distress and disability for patients. A review of 174 workers’ compensation patients treated for factitious hand disorders over a period of 29 years in a multidisciplinary hand center revealed four main categories of presentation: psychopathological dystonia, factitious edema, psychopathological complex regional pain syndrome, and factitious wound creation and manipulation. Significant differences were found between these categories in terms of demographics, utilization of medical resources, psychopathology, treatment modalities, and return-to-work status. Patients with factitious wounds were more educated, used more medical resources, demonstrated an angry or hostile profile, and had a lower return-to-work rate. Patients with dystonia were less educated, used fewer medical resources, demonstrated a hypochondriasis or depressed profile, and had a higher return-to-work rate. The treatment of factitious hand disorders remains frustrating and costly, with a high percentage of patients experiencing failure or recurrence of symptoms after traditional approaches. The authors emphasize the importance of a multidisciplinary approach that includes hand surgeons, occupational therapists, and psychologists to promptly identify and appropriately treat factitious hand disorders and to help build a strong doctor-patient relationship.

Keywords

factitious hand disorders

self-inflicted injuries

fabricated conditions

diagnostic challenge

distress and disability

psychopathological dystonia

factitious edema

complex regional pain syndrome

factitious wound creation

manipulation