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The Spectrum of Factitious Disorders

Edited by Marc D. Feldman, M.D., and Stuart J. Eisendrath, M.D.

  • ISBN 978-0-88048-909-6
  • Item #8909

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Factitious disorder presents one of the most challenging variants of psychopathology in medicine. The Spectrum of Factitious Disorders is the first book for professionals to offer a comprehensive overview of current thinking about patients who feign or induce illness—in themselves or others—to accrue the intangible benefits of the sick role.

Attempts to influence factitious patients' behavior have been largely unsuccessful. This volume covers innovative techniques for treating such patients, stressing the need to treat them with acceptance and understanding. First-person accounts are used to illustrate the intense feelings mobilized in friends, family members, caregivers, and patients themselves as factitious disorders play out. The book also presents a management approach that emphasizes respect for the patient, no matter what the symptomatology.

Using abundant case material, this revolutionary work aids mental health practitioners in understanding the phenomenon of disease-forgery and addresses its inherent management challenges. Notable contributors provide relevant information on ethical and legal issues in factitious disorders. The clinical features, detection, and management of factitious disorder by proxy are explored, along with comprehensive psychosocial assessment and legal issues in such cases.


  • Historical perspectives on the spectrum of sickness: from crock to crook. Current overview of factitious physical disorders. Factitious psychological disorders. Ethical and legal issues in factitious disorders: an overview. Factitious disorders and litigation. Factitious disorder by proxy: clinical features, detection, and management. Comprehensive psychosocial assessment in factitious disorder by proxy. Legal issues in factitious disorder by proxy. Hospital epidemics of factitious disorder by proxy. Personal and interpersonal toll of factitious disorders. Management of factitious disorders. Index.

About the Authors

Marc D. Feldman, M.D., is Associate Professor, Vice Chair for Clinical Services, and Director of the Division of Adult Psychiatry in the Department of Psychiatry and Behavioral Neurobiology at the University of Alabama, Birmingham (UAB). He is also Medical Director of the UAB Center for Psychiatric Medicine. Dr. Feldman has lectured widely to both professional and lay audiences and is the co-author of the book Patient or Pretender: Inside the Strange World of Factitious Disorders.

Stuart J. Eisendrath, M.D., is Director of the Consultation-Liaison Program at the University of California, San Francisco Medical Center, and a Professor of Clinical Psychiatry at the University of California, San Francisco School of Medicine.

This is a useful and important book by some of the leading authorities in the field. It represents the existing literature well. The sections of the book on legal and ethical aspects of factitious disorders, and the chapter on comprehensive assessment in factitious disorder by proxy are especially noteworthy contributions to the literature. . . . I have used The Spectrum of Factitious Disorders as a reference on a number of occasions already, and I assume this volume will remain a primary resource for clinicians for some time.—General Hospital Psychiatry

The book is a comprehensive but concise monograph that is highly readable. . . . Overall, The Spectrum of Factitious Disorders represents the most comprehensive book to date on the subject. Psychiatrists, clinical psychologists, social workers, nurse specialists, and therapists will benefit from this book, and it is a must for clinicians who regularly encounter these problems. It will serve as a great reference for legal professionals who are involved with such cases.—Psychiatric Services

This concise book is informative and useful; the mental health practitioner will use it repeatedly as the need arises.—American Journal of Psychiatry

This comprehensive overview of the spectrum of confusing clinical disorders known as factitious illness is essential for clinicians working in a consultation-liaison service. The authors elucidate the phenomenology and demographic descriptions of the factitious disorders, malingering, and Munchausen's by proxy from the understanding and clinical strategies to manage these vexing problems. It is the only volume that is solely dedicated to this topic and deserves to be in the library of all interested clinicians.—Thomas N. Wise, M.D., Editor-in-Chief, Psychosomatics

Drs. Feldman and Eisendrath have produced the first comprehensive text on the diagnosis and treatment of factitious disorders. The book not only offers historical and epidemiologic perspective on factitious disorders but presents in-depth psychodynamic insights as well. Clinicians will find The Spectrum of Factitious Disorders a definitive resource on the recognition and management of this complex clinical phenomenon. The text is particularly strong in medical-legal issues presented by factitious disorders including factitious disorder by proxy.—Alan Stoudemire, M.D., Professor of Psychiatry, Emory University School of Medicine, Atlanta, Georgia

The Spectrum of Factitious Disorders is a superb addition to the clinical practice series published by American Psychiatric Press. Drs. Marc Feldman and Stuart Eisendrath have assembled a prestigious group of experts who discuss, in practical terms, current issues with factitious disorders. . . . [A] timely contribution to our literature with a wealth of case material, many clinical insights, and practical considerations for management of factitious disorders, this book is a must for any clinician who regularly encounters this clinical problem.—David G. Folks, M.D., Professor and Chair, Department of Psychiatry, Creighton University School of Medicine, University of Nebraska Medical Center, Omaha, Nebraska

The book combines a scholarly review of all aspects of factitious illness, combining a historical approach with a careful yet colorful account of the more recently studied conditions such as factitious illness by proxy. There is sufficient detail to provide a vivid picture of the disruption and difficulties that such patients and families for those who try to help them, and much practical guidance about avoiding misdiagnosis and other mistakes, including litigation. I do not know of another similarly comprehensive book covering the many different facets of factitious disorders. It is fascinating and instructive.—Roy Meadow, M.D., President, British Pediatric Association

In case after case, this book demonstrates the seriousness of factitious disorders and their impact on family, friends, and practitioners in every medical specialty. This surprisingly comprehensive book is the first clinical guide to factitious disorders, and it is likely to remain for years the authoritative source in its field.—The New England Journal of Medicine

In all, The Spectrum of Factitious Disorders is a highly palatable, well-documented overview of the many variants of such disorder and current clinical thinking on the subject. It will make a notable addition to any therapists' library.—M.D. NEWS

I recommend this excellent book to all who are interested in better understanding a strange and troubling psychological phenomenon.—Newsletter of the Marin County Psychological Association

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