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- Title
Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report.
- Authors
Pozuelo Moyano, Beatriz; Duquenne, Catherine; Favrat, Bernard; Francois-Xavier, Borruat; Kokkinakis, Ioannis; Tzartzas, Konstantinos
- Abstract
Background: 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. Case presentation: 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. Conclusions: 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.
- Subjects
SICK leave; SOMATOFORM disorders; MEDICALLY unexplained symptoms; DISABILITIES; NEUROLOGICAL disorders; VISION disorders
- Publication
Journal of Medical Case Reports, 2023, Vol 17, Issue 1, p1
- ISSN
1752-1947
- Publication type
Case Study
- DOI
10.1186/s13256-023-04063-0