A case report of comorbid Munchausen type factitious disorder with bipolar II disorder

Abstract

We present an uncommon case of a 46-year-old woman suffering from Munchausen type factitious disorder comorbid with bipolar II disorder.The patient was diagnosed with major depression disorder 4 years ago during her hospitalization in the internal medicine department after a suicide attempt and SSRI was prescribed.Since the onset of the disorder the patient started complaining for physical symptoms, migrating from hospital to hospital seeking pathological and surgical interventions, fabulating her medical history. In the last 3 years, the patient visited the emergency room of university hospital of Ioannina 85 times and she was hospitalized in internal medicine or surgical clinics 16 times, performing 19CR, 11 CT and 4MRI.Many times, she turned to the police suing the treating doctors. During her hospitalizations she refused psychiatric evaluation. Twelve months ago the patient finally visited a psychiatrist, bipolar II disorder was diagnosed and administrated quetiapine with good results to both, mood and ER visits (7 visits in one year and 1 hospitalization).During the analysis of her mood switches, we observed non-euphoric hypomanic episodes and association of the hypomanic phase with the factitious behavior.This case report reinforces the importance of maintaining a clinical suspicion of major psychopathology coexistence with factitious disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.