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

There 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...

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Bibliographic Details
Published in:Journal of medical case reports 2023-08, Vol.17 (1), p.340-340, Article 340
Main Authors: Pozuelo Moyano, Beatriz, Duquenne, Catherine, Favrat, Bernard, Francois-Xavier, Borruat, Kokkinakis, Ioannis, Tzartzas, Konstantinos
Format: Article
Language:English
Subjects:
Age
Blindness
Case Report
Case reports
Diagnosis
Disability
Factitious disorder
Functional blindness
Patients
Physiological aspects
Primary care
Psychic trauma
Psychological aspects
Psychotherapy
Radiosurgery
Rape
Sex crimes
Somatoform disorder
Somatoform disorders
Stress (Psychology)
Visual impairment
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Summary:There 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. A 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. Blindness 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.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-023-04063-0