A systematic review of psychological treatments for women presenting with factitious disorder and factitious disorder imposed on another

Abstract

Background: Little is known about the psychological treatments for Factitious Disorder (FD) and Factitious Disorder Imposed on Another (FDIA) in women. The literature is limited and consists of case series and case reports. To date there has been no systematic review of the effectiveness of the psychological treatments. This review aims to identify which psychological treatments have been used to treat FD and FDIA, to hypothesise a psychological treatment strategy which can be implemented in clinical practice and evaluated in future research. The objective of this systematic review is to identify and summarise psychological treatments which have been effective when treating FD and FDIA in women.Methods: A total of 543 records were screened, and 29 remaining papers were reviewed. A supplementary search was then conducted using the reference lists of eligible studies. In total 29 eligible studies yielded a sample of 38 cases. Information extracted included study characteristics, type of psychological therapy, co-morbid disorders, other treatment methods, childhood maltreatment, effective and non-effective outcomes, clinical measures and follow up.Results: Our findings offer an important first step towards an evidence-based approach to the disorder. A narrative synthesis was undertaken to describe the characteristics, quality, and outcomes of studies. The narrative synthesis surveyed the state of knowledge and provided an overview and integration of psychological treatments of FD and FDIA in women.Conclusion: This review highlights there is no standardised approach for psychological treatment in FD and FDIA. It is recommended that consistency of care, a good therapeutic relationship, and adoption of a holistic and integrative approach to treatment which is grounded in individualised formulation may be fundamental in achieving effective outcomes. The fi dings provide a basis for several clinical recommendations and a robust first step towards an evidence-based approach for the psychological treatments of FD and FDIA in women.