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Complex Regional Pain Syndrome and Factitious Diso ...
Factitious Hand Disorders: Review of 29 Years of M ...
Factitious Hand Disorders: Review of 29 Years of Multidisciplinary Care
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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
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