Advanced Psychopathology Case Study
Abstract
Mary White suffers from 300.19 (F68.10) Factitious Disorder Imposed on Self. There is evidence to support the idea that Mary is inclined to cause harm to herself and seek the attention of the medical staff. Nevertheless, Mary does not follow the doctors’ recommendations and seems to find new reasons to visit a physician or to be hospitalized. The woman’s medical history lists diseases with unexplained and strange symptoms, therefore, it is possible to state that Mary can simulate and exaggerate her health problems, as it is typical for persons with Factitious Disorder.
Introduction to the Case Analysis
Mary White, a 35-year-old female, has consulted the doctor because of severe migraines which cannot be relieved with the help of different medicines. Mary is divorced. The woman has reported both physical and neurological problems, including double vision and nausea. It is found that the woman had a long history of hospitalizations and unexplained medical conditions. Symptoms of numerous diseases could appear without noticeable causes. However, Mary did not demonstrate concerns regarding her health state, and she was glad to receive help from the medical staff. Furthermore, there was evidence that Mary could harm herself and provoke vomiting as well as other symptoms. There was a situation when Mary was accused of harming herself, and then, she changed her place of living.
DSM–5 Diagnostic Presentation
Diagnostic Codes
Referring to the symptoms and signs described in the case study, it is possible to assume that Mary suffers from 300.19 (F68.10) Factitious Disorder Imposed on Self (American Psychiatric Association, 2013, p. 324). Some information in the case study allows speaking about 300.11 (F44.7) Conversion Disorder with mixed symptoms (American Psychiatric Association, 2013, p. 319). However, 300.19 (F68.10) Factitious Disorder Imposed on Self is a primary diagnosis.
Psychosocial and Environmental Factors
The possible factors that can influence the development of a disease in Mary are divorce and the move to the current place of living.
Assessment of Current Functioning
Symptoms described in the case study can be discussed as recurrent with the focus on intermittent episodes for 300.19 (F68.10) Factitious Disorder Imposed on Self. The level of dangerousness to self is rather high because of possible injuries and harmful behaviors (American Psychiatric Association, 2013, p. 325). Referring to 300.11 (F44.7) Conversion Disorder, it is possible to classify the symptoms as persistent and with the possible psychological stressor like a divorce (American Psychiatric Association, 2013, p. 319).
Discussion of the Evidence in Support of Diagnoses
300.19 (F68.10) Factitious Disorder Imposed on Self is a primary diagnosis that can be discussed as related to the case of Mary White. Persons suffering from Factitious Disorder are usually inclined to report a variety of diseases that have an unexplained nature, and the description of symptoms can be exaggerated to attract the medical staff’s attention. Therefore, the medical history can be rather long (Hamilton, Feldman, & Janata, 2009, p. 28). Mary reports extremely severe migraines that cannot be relieved; she has a long history of hospitalizations (20 hospitalizations for several years); she reports a variety of medical conditions of different nature, and many of her health problems cannot be explained.
Furthermore, persons with Factitious Disorder choose to avoid following the treatment recommendations made by doctors, but they need to consult physicians frequently. In addition to ignoring prescriptions, persons with Factitious Disorder can injure themselves and approve different surgical procedures that can be unnecessary for them. They can also lie about certain symptoms (Gray, 2011, p. 112; Hamilton et al., 2009, p. 29). It was mentioned that Mary did not follow prescriptions for treating the edema in their legs, and she did not take drugs appropriately, but she always visited a doctor on time and enjoyed speaking about her conditions. It was also fixed by cameras that Mary could harm herself while injecting the medication that caused her vomiting. Moreover, another case of vomiting could be provoked intentionally with Ipecac; however, there was no direct evidence to support this fact. Besides, Mary reported exploratory surgeries for finding the cause of symptoms.
Discussion of the Rationale for Ruling out Diagnoses
Mary was psychologically tested, and there were signs of 300.11 (F44.7) Conversion Disorder. However, the evidence demonstrates that this diagnosis needs to be excluded from the list of possible diagnoses for Mary. The reason is that persons having Conversion Disorder suffer from the disorder as a result of considerable psychological stress (American Psychiatric Association, 2013, p. 320). It is possible to assume that the divorce could influence Mary significantly, and she began to suffer from such mixed symptoms as double vision, fatigue, and nausea among others. However, tests did not demonstrate the signs of depression or similar problems in Mary. Instead, the evidence supports the idea that the woman intentionally caused harm to herself. Still, persons with Conversion Disorder suffer from somatic symptoms about which they do not lie.
Conclusion
Having analyzed symptoms and the details of Mary’s case and medical history, it is possible to state that the woman suffers from 300.19 (F68.10) Factitious Disorder Imposed on Self. There is evidence to support the idea that Mary is inclined to cause harm to herself and seek the attention of the medical staff. Nevertheless, Mary does not follow the doctors’ recommendations and seems to find new reasons to visit a physician or to be hospitalized. The woman’s medical history lists diseases with unexplained and strange symptoms, therefore, it is possible to state that Mary can simulate and exaggerate her health problems, as it is typical for persons with Factitious Disorder.
References
American Psychiatric Association. (2013). DSM 5: Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Publishing.
Gray, S. (2011). Competency-based assessments in mental health practice: Cases and practical applications. New York, NY: John Wiley & Sons.
Hamilton, J., Feldman, M., & Janata, J. (2009). The A, B, C’s of factitious disorder: A response to Turner. Medscape Journal of Medicine, 11(1), 27-32. Web.