title: [Are artificial disorders common in palliative care? A Case report].
abstract: The main task of palliative care specialists is to focus on symptom control such as pain, nausea or fatigue. Thorough anamnesis, physical examination, laboratory examination, and differential diagnosis can ensure appropriate treatment. In an increasing number of cases psychiatric conditions like depression or anxiety increase also occur so palliative care physicians need to be more prepared to handle them. The question of this case report is, how a palliative care specialist can distinguish between a malignant disease or neurological disease progression and a presentation primarily psychiatric in etiology, as is the case in factitious disorders. We are also interested in the incidence rate of such factitious disorders. Our case study demonstrates that it is rare but not impossible that a doctor will encounter factitious symptoms in the palliative setting. This suggest being aware of evidence of psychiatric origins even in discharge letters and referrals that indicate palliative care needs, to ensure that palliative care really is the best treatment option for the patient. We do believe such cases to be rare in a palliative setting, however.
authors.affiliation: Hospiz, Landespflegeheim Tulln, Frauenhofnerstraße 54, 3430, Tulln, Niederösterreich, Österreich. dagmar.porstner@noelandesheime.at.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Porstner
authors.affiliation: Innere Medizin I, Palliativstation, Medizinische Universität Wien, Währinger Guertel 18-20, 1090, Wien, Österreich. eva.masel@meduniwien.ac.at.
authors.forename: Eva K
authors.initials: EK
authors.lastname: Masel
authors.affiliation: , Untere Landstraße 6, 3500, Krems an der Donau, Niederösterreich, Österreich. ursulaheck@mac.com.
authors.forename: Ursula
authors.initials: U
authors.lastname: Heck
mesh_terms: D000328:Adult; D001317:Austria; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D005162:Factitious Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006301:Health Services Needs and Demand; D017051:Hospice Care; D006801:Humans; D033183:Interdisciplinary Communication; D009110:Munchausen Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D010148:Intractable Pain / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D010166:Palliative Care / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D012017:Referral and Consultation
keywords: Factitious disorder; Hospice care; Palliative care; Psychic disorder