Factitious disorder comorbid with borderline personality disorder and dysthymia: from [MUPS] to [FND] 2023 Lazzari et al

[Andy]

Full title: Factitious disorder comorbid with borderline personality disorder and dysthymia: from medically unexplained physical symptoms to functional neurological disorder

Summary. Introduction. In this study, we introduce the concept of comorbidity between factitious disorder (FD), borderline personality disorder (BPD), dysthymia (DY), medically unexplained physical symptoms (MUPS) and functional neurological disorder (FND) characterising patients who may tend to exaggerate physical or psychiatric symptoms of presentation to a general or psychiatric hospital with a constellation of signs that do not receive confirmation from further clinical and instrumental assessments. The similarities between these syndromes and the constant presence of borderline personality in the psychopathology make it the possible link between all these syndromes.

Materials and methods. The authors captured the typical appearance and characterisation of FD-BPD-DY-MUPS-FND (Com-1) syndrome in adult and non-forensic acute psychiatric hospitals in the United Kingdom (UK) and adjacent liaison psychiatric teams through case vignettes. Each case vignette merged similar clinical cases and was cross-analysed using information from various mental health and medical professionals and bridging primary and secondary carers’ records.

Results. The findings suggest striking similarities between the syndromes making borderline personality the bridge pathology for FD, MUPS and FND. The complexity of the diagnosis of these cases is discussed in the study, together with prototypical presentations.

Conclusions. Improving the management of these often-occurring diseases requires multidisciplinary coordination across psychiatry, general care, neurology and surgery departments.

Open access, https://www.rivistadipsichiatria.it/archivio/4113/articoli/41070/

 

[Andy]

"Medically Unexplained Physical Symptoms (MUPS) is an umbrella term to refer to conditions defined by physical symptoms not better described by another disorder20,21. According to estimates, about 20% (15% to 30%) of patients in primary care have chronic symptom disorders or medically unexplained syndromes, such as fibromyalgia or chronic fatigue syndrome"

 

[duncan]

The findings suggest striking similarities between the syndromes making borderline personality the bridge pathology for FD, MUPS and FND.

No surprises, I suppose. People with screwed up personalities invent or imagine all sorts of whacked out nonsense about their own bodies and whatnot. (insert sarcasm emoji here) Years ago, these were probably the kids no one would let sit with them at lunch time or study hall. (insert sarcasm emoji here)

So mean girls had it right all along.

Is this where medical researching is headed?

 

[Trish]

That sounds very judgemental, @duncan.

I suspect a lot of the so called overlap between so called borderline personality disorder and so called MUS has more to do with diagnostic incompetence and prejudice by clinicians rather than anything real for patients.

 

[duncan]

hat sounds very judgemental, @duncan.

It was sarcasm. Evidently failed sarcasm. I've added qualifiers to my original post.

No worries. I agree with you:

I suspect a lot of the so called overlap between so called borderline personality disorder and so called MUS has more to do with diagnostic incompetence and prejudice by clinicians rather than anything real for patients.

 

[Trish]

It was sarcasm. Evidently failed sarcasm. I've added qualifiers to my original post.

Ah, thanks for clarifying, my sarcasm detector failed!

 

[bobbler]

The author might as well just have written ‘I’m a huge misogynist and so am rolling together all of the nastiest most power-stealing and weaponising labels together as a roll call list for anyone else who really wants to do over someone whose face doesn’t fit’ on the basis of these terms being those most commonly weaponised and used by misogynists against women in particular (tho not exclusively women - misogyny being a complicated beast if u is s also often women doing it). All of these have at some point almost come with instructions to others if diagnosing based on demographics eg ‘10% of young women, particularly those who might have had trauma at some point’ (hardly medical)

the one thing that sounds accurate is the term “each case vignette” which means those making ‘diagnoses’ were engaging in their usual storytelling not medicine about the poor target and if there wasn’t trauma or something in someone’s history then why not extract or invent?

at least it seems we’ve someone who even if any of these ever did have any behind them is confirming that in the hands of certain types they just mean ‘weapon label’ and say more about the labeller, what they are trying to do to their target, who they are trying to convince (audience) than the labelee?

 

[bobbler]

It was sarcasm. Evidently failed sarcasm. I've added qualifiers to my original post.

No worries. I agree with you:

no I read the sarcasm/intended tone - the stories told in this article snd the tone of them is pretty shocking and I implore anyone to scroll down and read in full how this author had clearly picked out some ‘anecdotes’ true or not that maximise shock factor and other judgment snd I guess are about citing stigma and priming future healthcare professions to see things that aren’t there based on stuff he maybe hadn’t verified 100% rather than ‘represent’ the areas that are getting dragged in

it’s not a nice ‘inside the minds eye’ sight

 

[Arnie Pye]

dysthymia

medically unexplained physical symptoms

So, someone has a medical condition that doctors have failed to diagnose so is therefore medically unexplained. We all know this can happen and may go on for years or even decades. Dysthmia is a "persistent depressive disorder". If someone has a medical condition that doesn't get diagnosed and is therefore either left untreated or is treated with anti-depressants then being depressed is a perfectly normal and sane response (in my opinion) to the situation the patient is in.