EXPANDED PROFILE OF THE SHAFT SYNDROME

The SHAFT syndrome is a factitious disorder in which a patient manipul ates the surgeon to perform operations to fulfill his or her psycholog ical needs. The acronym describes patients who are sad, hostile, anxio us, frustrating, and tenacious. A chart review from January 1990 to Ju ne 1996 was undertaken to provide a profile to aid in the recognition and diagnosis of the SHAFT syndrome. An analysis of 28 patients reveal ed characteristics supporting a definitive SHAFT profile. Patients wit h SHAFT syndrome seek physicians to perform invasive procedures. Their typical complaint is pain, usually without objective physical finding s that would support a more definitive diagnosis, Such patients tend t o be women, cry with pain, describe symptoms out of proportion to obje ctive findings, and have a history of psychiatric care. Copyright (C) 1998 by the American Society for Surgery of the Hand.