Exaggerating, mislabeling or simulating obsessive-compulsive symptoms: Case reports of patients claiming to have obsessive-compulsive disorder

dc.contributor.authorFontenelle, Leonardo F.
dc.contributor.authorLins-Martins, Natalia M.
dc.contributor.authorMelca, Isabela A.
dc.contributor.authorLima, Andre Luis C.
dc.contributor.authorMenezes, Gabriela B. de
dc.contributor.authorTorres, Albina Rodrigues [UNESP]
dc.contributor.authorYuecel, Murat
dc.contributor.authorMiguel, Euripedes C.
dc.contributor.authorMendlowicz, Mauro V.
dc.contributor.institutionUniversidade Federal do Rio de Janeiro (UFRJ)
dc.contributor.institutionInst DOr Pesquisa & Ensino IDOR
dc.contributor.institutionUniversidade Federal Fluminense (UFF)
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionMonash Univ
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.date.accessioned2014-12-03T13:10:35Z
dc.date.available2014-12-03T13:10:35Z
dc.date.issued2014-07-01
dc.description.abstractBackground: There are no reported cases of factitious or simulated obsessive compulsive disorder (OCD). However, over the last years, our clinic has come across a number of individuals that seem to exaggerate, mislabel or even intentionally produce obsessive and/or compulsive symptoms in order to be diagnosed with OCD.Methods: In this study, experienced clinicians working on a university-based OCD clinic were requested to provide clinical vignettes of patients who, despite having a formal diagnosis of OCD, were felt to display non-genuine forms of this condition.Results: Ten non-consecutive patients with a self-proclaimed diagnosis of OCD were identified and described. Although patients were diagnosed with OCD according to various structured interviews, they exhibited diverse combinations of the following features: (i) overly technical and/or doctrinaire description of their symptoms, (ii) mounting irritability, as the interviewer attempts to unveil the underlying nature of these descriptions; (iii) marked shifts in symptom patterns and disease course; (iv) an affirmative yes pattern of response to interview questions; (v) multiple Axis I psychiatric disorders; (vi) cluster B features; (vii) an erratic pattern of treatment response; and (viii) excessive or contradictory drug-related side effects.Conclusions: In sum, reliance on overly structured assessments conducted by insufficiently trained or naive personnel may result in invalid OCD diagnoses, particularly those that leave no room for clinical judgment. (C) 2014 Elsevier Inc. All rights reserved.en
dc.description.affiliationUniv Fed Rio de Janeiro, Inst Psiquiatria, Anxiety & Obsess Compuls Disorders Res Program, BR-22410003 Rio De Janeiro, RJ, Brazil
dc.description.affiliationInst DOr Pesquisa & Ensino IDOR, Rio De Janeiro, Brazil
dc.description.affiliationUniv Fed Fluminense, Inst Saude Comunidade, Dept Psiquiatria & Saude Mental, Niteroi, RJ, Brazil
dc.description.affiliationUniv Estadual Paulista UNESP, Dept Neurol Psicol & Psiquiatria, Botucatu, SP, Brazil
dc.description.affiliationMonash Univ, Sch Psychol Sci, Melbourne, Vic 3004, Australia
dc.description.affiliationUniv Sao Paulo, Dept Psiquiatria, Sao Paulo, Brazil
dc.description.affiliationUnespUniv Estadual Paulista UNESP, Dept Neurol Psicol & Psiquiatria, Botucatu, SP, Brazil
dc.format.extent1188-1194
dc.identifierhttp://dx.doi.org/10.1016/j.comppsych.2014.03.023
dc.identifier.citationComprehensive Psychiatry. Philadelphia: W B Saunders Co-elsevier Inc, v. 55, n. 5, p. 1188-1194, 2014.
dc.identifier.doi10.1016/j.comppsych.2014.03.023
dc.identifier.issn0010-440X
dc.identifier.lattes3837157956819433
dc.identifier.urihttp://hdl.handle.net/11449/112275
dc.identifier.wosWOS:000337850300019
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofComprehensive Psychiatry
dc.relation.ispartofjcr2.128
dc.rights.accessRightsAcesso restrito
dc.sourceWeb of Science
dc.titleExaggerating, mislabeling or simulating obsessive-compulsive symptoms: Case reports of patients claiming to have obsessive-compulsive disorderen
dc.typeArtigo
dcterms.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dcterms.rightsHolderElsevier B.V.
unesp.author.lattes3837157956819433[6]
unesp.author.orcid0000-0001-9075-8226[1]
unesp.author.orcid0000-0002-4705-452X[7]
unesp.author.orcid0000-0003-1072-5008[6]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt
unesp.departmentNeurologia, Psicologia e Psiquiatria - FMBpt

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