Abstract

AbstractThirty-six coses in which anticoagulants have been turned to nontherapeutic (or “disease”-producing) purposes have been reported. Most patients, referred to as “Dicumarol-eaters,” are women who are members of the medical profession or persons previously treated with an anticoagulant. Other cases of factitious bleeding disease can be subsumed under the headings of factitious bleeding and anemia. Twelve patients with factitious bleeding, culled from the literature on Munchausen's syndrome, were predominantly men and not engaged in a medically related field. Of four patients who produced anemia by self-bloodletting, all were women and two were associated with the medical profession. Patients with factitious illnesses have a need to assume the patient role. To do so, they must deceive their, physicians. Treatment of factitious blood disease is difficult and prognosis is usually poor. Psychiatric referral is indicated, but even when proposed in a careful and sensitive manner, it is likely to be refused.