Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report

Journal of Medical Case Reports

Case Report

Ioannis Kokkinakis¹  Bernard Favrat¹  Beatriz Pozuelo Moyano¹  Catherine Duquenne¹  Konstantinos Tzartzas¹  Borruat Francois-Xavier² 

[1] Center for Primary Care and Public Health (Unisanté), University of Lausanne, Rue du Bugnon 44, 1011, Lausanne, Switzerland;Neuro-Ophtalmology Unit, Hospital of Jules-Gonin, Lausanne, Switzerland;

关键词: Somatoform disorder;    Factitious disorder;    Disability;    Functional blindness;   

DOI  :  10.1186/s13256-023-04063-0

 received in 2022-05-23, accepted in 2023-07-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere is a high prevalence of somatoform disorders and medically unexplained symptoms. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder. The case presented demonstrates the impact on disability benefits and the subsequent psychosocial repercussions of misdiagnosing between a factitious disorder and a somatoform disorder.Case presentationA 42-year-old Caucasian woman worked as a 100% fiduciary accountant until the age of 32 when she was placed on medical leave due to persistent trigeminal neuralgia. Afterward, she developed total blindness, not explained by a physiological process, accompanied by distress in a crucial emotional context. We evaluated the patient for a revision of a disability income after a diagnosis of factitious disorder with severe consequences such as disability income suspension and family conflict. Our psychiatric examination concluded the diagnoses of pain disorders related to psychological factors and a dissociative neurological symptom disorder with visual disturbance.ConclusionsBlindness not explained by a physiological process may accompany trauma and psychological distress. Differentiating this pathology from factitious disorder or simulation is essential from an insurance medicine point of view, but also for its treatment.

【 授权许可】

CC BY   
© The Author(s) 2023