Epidemiology and evolution of the diagnostic classification of factitious disorders in DSM-5

Figures & data

Figure 1 PRISMA flow chart.

Table 1 Basic demographic characteristics of patients diagnosed with FD

	N	Percent
Gender
Male	176	34.2
Female	336	65.4
Marital status
Unmarried	62	30.4
Married	97	47.5
Separated/divorced/widowed	45	22.0
Age (years)
Total mean	33.5
Male	35
Female	32.8
Total range	18–73
Male range	19–67
Female range	18–73
Comorbid psychopathology	239	46.5
Occupation
Health care profession	113	22.0
Others	94	18.3

Abbreviation: FD, factitious disorder.

Table 2 Clinical presentation

	N	Percent	Clinical presentation
Neurology and neurosurgery	51	9.9	Undefined neurological syndrome (n=9); paralysis (n=12); epilepsy (n=12); paresis (n=1); multiple sclerosis (n=3); dystonia/apraxia (n=3); dysarthria (n=1); precoma (n=1); post-polio syndrome (n=2); neuropathy (n=2); migraine headache (n=1); vascular dementia (n=1); amnesia (n=2); subarachnoid hemorrhage (n=1)
Psychiatry	95	18.5	Munchausen syndrome (n=31); PTSD (n=15); depression (n=8); schizophrenia (n=3); suicide (n=1); hermaphroditism (n=1); psychic symptoms (n=36)
Rheumatology and allergology	23	4.5	Osteoarticular pain (n=11); arthritis (n=5); allergy (n=2); Raynaud’s phenomenon (n=2); SLE (n=1); collagenopathy (n=1); granulomatous disease (n=1)
Infectious and tropical diseases	44	8.6	AIDS/HIV (n=19); infection (n=16); FUO (n=6); endocarditis (n=1); parasitosis (n=1); tropical disease (n=1)
Respiratory department	13	2.5	Respiratory tract hemorrhage (n=6); ARDS (n=3); asthma (n=2); pulmonary emphysema (n=1); pulmonary fibrosis (n=1)
Endocrinology	29	5.6	Cushing syndrome (n=11); hypoglycemia(n=11); feocromocytoma (n=3); hyperthyroidism (n=2); hypercortisoluria (n=1); ketoacidosis (n=1)
Nephrology and urology	18	3.5	Urinary calculi (n=6); urinary hemorrhage (n=6); GN (n=2); urinary retention (n=1); UTIs (n=1); proteinuria (n=1); Fournier gangrene (n=1)
Dermatology	44	8.6	Skin ulcer (n=10); panniculitis (n=8); skin lesion (n=7); subcutaneous abscess (n=6); lower body edema (n=4); dermatitis (n=4); cyanosis (n=2); subcutaneous masses (n=1); subcutaneous hemorrhage (n=1); fistula (n=1)
Cardiology and angiology	20	3.9	MI (n=5); chest pain (n=4); lipothymia/syncope (n=3); hypertension (n=3); DVT (n=2); arrhythmia (n=1); hypovolemia (n=1); cardiocirculatory failure (n=1)
Gynecology and midwifery	9	1.8	Vaginal bleeding (n=4); premature birth (n=2); complicated pregnancy (n=1); hyperemesis gravidarum (n=1); breast pain (n=1)
Hematology	22	4.3	Anemia (n=15); coagulopathy (n=3); mastocytosis/thrombocytopenia (n=2); hypogammaglobulinemia (n=1); hemophilia (n=1)
Gastroenterology	23	4.5	Abdominal pain (n=9); gastrointestinal hemorrhage (n=5); hyperemesis (n=3); diarrhea (n=2); intestinal occlusion (n=1); acute abdomen (n=1); IBD (n=1); cystic fibrosis (n=1)
Otolaryngology and ophthalmology	19	3.7	Blindness (n=5); ORL symptoms (n=3); nasal hemorrhage (n=2); corneal injury (n=2); Ludwig’s angina (n=1); deaf-dumbness (n=1); stomatitis (n=1); Usher syndrome (n=1); otitis (n=1); endophthalmitis (n=1); ear hemorrhage (n=1)
Traumatology and emergency room	60	11.7	Wounds (n=16); trauma/polytrauma (n=11); hemorrhage NOS (n=9); pneumothorax (n=4); burn (n=3); subcutaneous emphysema (n=3); decompression sickness (n=3); angioedema (n=3); poisoning (n=2); aortic dissection (n=2); electrolytic disorders (n=2); osteonecrosis (n=1); anaphylaxis (n=1)
Oncology	10	1.9	Cancer NOS (n=8); breast cancer (n=2)
Genetics	1	0.2	Disease NOS (n=1)
Intensive and palliative care	14	2.7	Chronic pain (n=6); post-surgical pain (n=5); complications of anesthesia (n=2); neuropathic pain (n=1)
Undefined physical symptoms	14	2.7
Undefined symptoms	5	1.0

Abbreviations: AIDS, acquired immune deficiency syndrome; ARDS, acute respiratory distress syndrome; DVT, deep vein thrombosis; FUO, fever of unknown origin; GN, glomerulonephritis; HIV, human immunodeficiency virus; IBD, inflammatory bowel disease; MI, myocardial infarction; NOS, not otherwise specificated; ORL, otolaryngologic; PTSD, posttraumatic stress disorder; SLE, systemic lupus erythematosus; UTIs, urinary tract infections.