A 28 year old business man returned from a trip from Kenya 2 years ago. He attends a sexual clinic worried that he has contracted HIV. Antibody screening test for HIV has come back negative. There were 2 similar HIV test performed 6 months and 9 months
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ago which have both come back as negative. This is his 5th visit to the clinic claiming that he is HIV positive. What is the SINGLE most likely diagnosis?
A. Somatization disorder
B. Hypochondriasis
C. Munchausen’s syndrome
D. Conversion disorder
E. Malingering
Hypochondriasis → is the persistent belief in the presence of an underlying serious DISEASE, e.g. cancer or HIV. The patient again refuses to accept reassurance or negative test results. Somatization disorder →The experience of bodily symptoms with no physical cause for them, with presumed psychological causation… The patient refuses to accept reassurance or negative test results Munchausen’s syndrome → also known as factitious disorder. Patients intentionally falsify their symptoms and past history and fabricate signs of physical or mental disorder with the primary aim of obtaining medical attention and treatment. The diagnostic features are the intentional and conscious production of signs, falsification, or exaggeration of the history and the lack of gain beyond medical attention and treatment. Conversion (dissociative) disorders → typically involves loss or disturbance of normal motor or sensory function which initially appears to have a neurological or other physical cause but is later attributed to a psychological cause. The patient does not consciously feign the symptoms or seek material gain. Patients may be indifferent to their apparent disorder. Malingering → Deliberately falsifying the symptoms of illness for a secondary gain (e.g. for compensation, to avoid military service, or to obtain an opiate prescription).