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F68.10 Factitious Disorder Imposed on Self F19.10 Other (or Unknown) Substance Use Disorder, Mild Z62.820 Parent-Child Relational Problem Sampaguita’s history of presenting unusual and dramatic symptoms that defy conventional medical understanding, her repeated overdoses, self-harm, and her use of drugs to induce or aggravate symptoms align with the diagnostic criteria for Factitious Disorder Imposed on Self. This includes falsification of physical or psychological signs or symptoms and deceptive behavior even in the absence of obvious external rewards. Sampaguita reports using many different drugs, which she sneaks from the hospital where she works. This behavior suggests a pattern of substance use that could meet the criteria for a Substance Use Disorder. Specifically, the mild specifier is used because the case does not provide enough information to suggest a more severe level of substance use. The differential diagnoses I was leaning towards was Munchausen Syndrome which I excluded because Sampaguita does not appear to be feigning illness solely to gain attention or sympathy but rather to induce actual physical symptoms. Another diagnosis I might have chosen was borderline personality disorder but excluded it because, while Sampaguita exhibits some features such as unstable relationships and self-harming behavior, she does not meet all the criteria, such as chronic feelings of emptiness and intense fear of abandonment.

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