Phenomenology and outcome of factitious disorders in otolaryngology clinic in Oman
Author: Bhargava D, Al Abri R, Rizvi SG, Al Okbi MH, Bhargava K, Al Adawi S
Source:
The International Journal of Psychiatry in Medicine, 37(2), 229-240.
The phenomenology of factitious disorders from the Arab part of the world has
been lacking in the medical literature and few reports have emerged from
otolaryngology. Using an observational prospective case series study (n = 19)
with long-term follow-up (two to six years), the present study reports the
magnitude and mode of clinical profile of factitious disorders in a tertiary care
hospital in Oman, an Arab-Islamic country. The outcome was operationalized as
prognosis following culturally sensitive intervention akin to confrontation
technique. The present observation suggests the prevalence of factitious
disorders in the otolaryngology tertiary care setting was 0.2%. Approximately
42.1% (n = 8) had hemorrhagic factitious disorders, 15.8% (n = 3) were those who
feigned for multiple surgical interventions. Approximately 15.8% (n = 3)
presented neurological factitious disorders while the remaining 26.3% (n = 5)
clinical profile suggested minor feigned illnesses. Objective "evidence factitia"
was present in 68.4% (n = 13) of the cases. On subsequent follow-up, nine
patients with chronic forms became asymptomatic, three patients had fewer
episodes, four patients were unchanged, and three patients were lost to
follow-up. The prognosis was good in patients who did not have associated
psychiatric illnesses as compared to those with psychiatric disorders. Factitious
disorders are often incorrectly diagnosed, with all consequences in terms of
adverse sequels. The observed good prognostic outcomes are discussed in the
context of socio-cultural patterning and the factors that may shape the
presentation of factitious disorders in Oman.