Introduction: About 1% of psychiatric consultations are concerned with a Factitious Disorder. Unlike malingering, Factitious Disorder is a special psychiatric Disorder that should be taken into consideration by the medical staff, . Case Presentation: This case reports a woman with fever and epistaxis as a primary clinical manifestation of a Factitious Disorder which was diagnosed and treated after further investigation and psychiatric consultation. Conclusions: Procrastination of diagnosis usually leads to an increase in the length of stay for unnecessary clinical and paraclinical investigations. The purpose of this case presentation was to raise the issue of psychiatric problems and their importance alongside physical problems.

Background: Factitious Disorder (FD) is a psychiatric condition in which the affected person deliberately makes up diseases, injuries, or symptoms. Diagnosing this condition is a serious medical challenge. No studies have been conducted in Iran to show these patients’,clinical and demographic profiles in an adequate sample size. The present article attempts to extract demographic and clinical details of Iranian FD patients by reviewing the related published articles. Methods: A search was conducted on this Disorder in English and Persian articles published by Iranian researchers between 1960 and 2020 in the MEDLINE, Web of Science, EMBASE, PsychInfo, Google Scholar, and SID databases using factit*, artefacta*, artefactua*, and Munchausen* as keywords in combination with “, by proxy”,and “, imposed upon another”, . Ultimately, 33 case report articles and 35 cases in total were included in the study, and demographic and clinical details of patients were extracted from the articles. Results: Of the 35 FD patients, 27 were women. The patients’,mean age was 32. 5 years. Factors leading physicians to the diagnosis of FD were atypical presentation (n = 18) followed by an unsubstantiated presentation. FD symptoms were mainly physical (n = 31), and reporting unusual and atypical wounds were the most common cause of patients’,visits, with a frequency of 25%. Most patients had not undergone a thorough psychiatric examination, and in those who had been evaluated, the most common diagnoses reported were mood Disorder and anxiety Disorder. Conclusion: It appears that greater attention is required to teach the diagnosis and assessment of FD.

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Individuals with Factitious Disorder fake illnesses to assume a sick role. They simulate, induce, or aggravate illness, often inflicting painful, deforming, or even life-threatening injury on themselves or those under their care. Factitious Disorders are diagnosed in about one percent of patients who are seen in psychiatric consultation in general hospitals. One of the features, that are overrepresented in patients with Factitious Disorders include: normal or above-average Intelligence Quotient (IQ). Authors describe a rare comorbidity of Factitious Disorders and intellectual disability.

Introduction: In Factitious Disorder (Munchausen syndrome), patients induce or aggravate symptoms of physical or psychological illness to receive attention and medical treatment. The motivation of these patients is merely getting a sick role and medical care, and entering the medical system; most of these patients have simultaneous mood Disorders (especially depression), or personality Disorders. Patients with Factitious Disorder have no secondary gain. Case Presentation: Herein, we present a middle-aged Azerbaijani man from Sarab city, East Azerbaijan who referred to hospital with complaints of abdominal and leg pain. Based on examinations, he had undergone repeated surgical procedures (laparotomy and surgical removal of the external object from the leg) due to the presence of a foreign body (needle and nail) in the intestines and leg’ s calf. The interview was done based on DSM-5 by a psychiatrist and after a two-month follow-up, the diagnosis was affirmed by a second opinion through a ground round session at the department of psychiatry, Tabriz university of medical sciences, Tabriz, Iran. He is under treatment with an SSRI along with cognitive psychotherapy. Conclusions: Patients with atypical and unusual manifestations of an illness associated with frequent hospital admissions and receiving multiple therapies can lead us to the diagnosis of a Factitious Disorder. Although patients often deny their disease and evade treatment, he was ultimately diagnosed with Factitious Disorder and received psychiatric treatment. The treatment goal is to reduce mortality and morbidity and to treat the underlying psychiatric Disorder.