THE HYPOTHESIS OF A TRIPOLAR SYNDROME IN LIAISON PSYCHIATRY AND MEDICINE: DEPRESSION COMORBID WITH FACTITIOUS DISORDERS AND BORDERLINE PERSONALITY DISORDER

Introduction. During recent years, there has been an increased incidence of hospital admissions in general adult psychiatry of patients presenting with comorbid Factitious Disorders, Borderline Personality Disorder and Depression. This clinical triad here named as Tripolar Syndrome can generate an articulate process of diagnosis and treatment. Patients with Tripolar Syndrome might tend to exaggerate or distort the gravity of their depression with suicidal ideation, and associated physical symptoms. Material and Methods. The authors used case vignettes and focus groups to identify the Tripolar Syndrome while improving the understanding of this standard presentation in adult and non-forensic acute psychiatric wards in the United Kingdom. Data collected from multiple mental and medical specialists helped to cross-analyze every single case. Results. The authors hypothesized that patients suffering from the Tripolar Syndrome have an underlying proclivity to use depressive and physical symptoms to exercise leverage on medical decisions while aiming to extensive and unnecessary physical and surgical treatments. Conclusion. The management of patients presenting with the Tripolar Syndrome is not easy. These patients are usually reluctant to be discharged from hospital as they quickly adapt to the role of patients. Besides, these patients use exaggerated psychical and mental symptoms to communicate their distress. Therefore, detailed knowledge of the tripolar syndrome as well as specific interventions and liaison between psychiatry, general medicine, and surgery are vital to improving the outcome of this frequently occurring syndrome.