Citation

Grunert BK, Sanger JR, Matloub HS, Yousif NJ. J. Hand Surg. Am. 1991; 16(6): 1027-1030.

Affiliation

Department of Psychology, Medical College of Wisconsin, Milwaukee, Wis.

Comment In:

J Hand Surg Am 1992;17(5):976

Copyright

(Copyright © 1991, American Society for Surgery of the Hand, Publisher Elsevier Publishing)

DOI

unavailable

PMID

1748746

Abstract

We evaluated 29 patients with factitious disorders in the hand who received Worker's Compensation benefits. Three types of factitious hand disorders based on physical presentation were self-mutilation and wound manipulation, edema, and finger and hand deformities. Two distinct psychological diagnoses present were factitious disorder with physical symptoms and conversion disorder. The Minnesota Multiphasic Personality Inventory revealed two personality profiles: emotionally dependent and angry and hostile. Behavioral treatment was implemented. The emotionally dependent group responded well, with 80% returning to work. The angry and hostile group had a much poorer response, with 21% returning to work. None of the self-multilating patients returned to work. We recommend a combined evaluation by a physician, a psychologist, and a hand therapist to achieve a definitive diagnosis for these disorders. The identification of psychological profiles assists in ascertaining which patients will be responsive to behavioral treatment.

Language: en