A scoping review of treatment for factitious disorder (imposed on self)

Introduction

Factitious disorder imposed on self (FDIS) has a deleterious impact on sufferers through the sequalae of induced illness as well as the consequences of unnecessary investigations and treatments.

Objective

This scoping review aimed to map the existing literature regarding the types of data, data quality, treatment options and outcomes, and changes in treatment approaches over time.

Method

A search was performed using Ovid Medline, Ovid Embase, Ovid PsycINFO, Cumulated Index in Nursing and Allied Health Literature (CINAHL), Central Register of Controlled Trials, Scopus, and Google Scholar.

Results

Seventy-two studies were included (71 case reports and one case series) relating to the management of 107 participants. The quality of reporting was limited for 61 % of studies. The most common factitious illnesses were dermatological manipulation creating a skin lesion, anaemia, and bleeding. The most common treatments were supportive psychotherapy, psychiatric hospitalization, and antidepressants. Mapping publications across time revealed that 50 % of all data were published after 2011, and medication treatments became more common over time. Confrontation was reported in 40 % of participants.

Conclusions

Evidence has expanded slightly in the past 17 years and this data remains exclusively at the case study level. Data relating to management were of poor quality and incompletely reported. The high frequency of confrontation and positive outcomes reported is suggestive of selection and publication bias.