RESUMO
In reality, the lines between factitious disorder, functional disorder, and malingering are quite blurred. In factitious disorder and malingering, patients consciously and deliberately create false medical and/or psychiatric symptoms for self-gain, often approaching multiple healthcare facilities to evade detection. Although the factitious disorder is pervasive, and the literature lacks accurate and consistent information, comorbidity with nonepileptic seizure (NES, a component of functional disorder) is quite commonly documented. In our case, the patient feigned multiple symptoms including two seizures and a shoulder dislocation to gain access to opioids. The clinical picture was only significant for alcohol withdrawal, aspiration pneumonia (possibly intubation vs. NES-related), and self-induced shoulder dislocation. Generally, management of these disorders should involve multiple specialties, multiple approaches, and identifying the triggering and comorbid psychological disorders, such as abandonment issues, personality disorders, physical or emotional abuse, anxiety, depression, stress, and substance use. Blindly approaching patients with a factitious disorder or malingering will not lead to any productive outcomes. Perhaps, creating a patient database could help reduce futile efforts while providing patients with the required help. This case report describes the presentation, diagnosis, management, and outcomes related to a patient with NES, engaging the reader to decipher the most appropriate diagnosis.
RESUMO
Post-acute sequelae of COVID-19 (PASC) or more commonly known as Long COVID-19, is the term given to persistent symptoms 12 weeks from the initial presentation of COVID-19 infection. Several multi-organ symptoms have been reported by patients. Some common symptoms include headaches, fatigue, memory impairment and mental health complications such as anxiety and depression. People with previous psychiatric diagnosis are at greater risk of developing longer mental health implications from persistent COVID-19 symptoms. Additionally, healthcare workers are at increased risk of being long haulers leading to burnout and exhaustion. The objective of this review article is to provide comprehensive evidence from existing literature on various symptoms reported by patients experiencing Long COVID-19 and the rate of occurrence of such symptoms in different populations. A long-term disease surveillance is required to further understand the persistent symptoms or the long-term impact of this infection.
