Psychology Facts

▲ Factitious Disorder ▲

》Factitious disorder is a serious mental health disorder in which a person appears sick or produces physical or mental illness. People with factitious disorder deliberately produce symptoms of an illness for the purpose of receiving care and attention in a medical setting. The symptoms aren't intended to get them practical benefits — the gain is believed to be mainly psychological.

》Factitious disorders are similar to another group of mental disorders called somatoform disorders, which also involve the presence of symptoms that are not due to actual physical illness or another mental illness. The main difference between the two groups of disorders is that people with somatoform disorders do not fake symptoms or mislead others about their symptoms on purpose.

》There are four main types of factitious disorders, including:

Factitious disorder with mostly psychological symptoms:
As the description implies, people with this disorder mimic behavior that is typical of a mental illness, such as schizophrenia. They may appear confused, make absurd statements and report hallucinations, the experience of sensing things that are not there; for example, hearing voices. Ganser syndrome, sometimes called prison psychosis, is a factitious disorder that was first observed in prisoners. People with Ganser syndrome have short-term episodes of bizarre behavior similar to that shown by people with serious mental illnesses.

Factitious disorder with mostly physical symptoms:
People with this disorder claim to have symptoms related to a physical illness, such as symptoms of chest pain, stomach problems, or fever. This disorder is sometimes referred to as Munchausen syndrome, named for Baron von Munchausen, an 18th century German officer who was known for embellishing the stories of his life and experiences.

Factitious disorder with both psychological and physical symptoms:
People with this disorder produce symptoms of both physical and mental illness.

Factitious disorder not otherwise specified:
This type includes a disorder called factitious disorder by proxy (also called Munchausen syndrome by proxy). People with this disorder produce or fabricate symptoms of illness in another person under their care. It most often occurs in mothers (although it can occur in fathers) who intentionally harm their children in order to receive attention.

》Possible warning signs of factitious disorder include:

Dramatic but inconsistent medical history.

Unclear symptoms that aren't controllable, become more severe or change once treatment has begun.

Unpredictable relapses following improvement in the condition.

Extensive knowledge of hospitals and/or medical terminology, as well as the textbook descriptions of illness.

Presence of many surgical scars.

Appearance of new or additional symptoms following negative test results.

Presence of symptoms only when the patient is alone or not being observed.

Willingness or eagerness to have medical tests, operations or other procedures.

History of seeking treatment at many hospitals, clinics and doctors' offices, possibly even in different cities.

Reluctance by the patient to allow healthcare professionals to meet with or talk to family members, friends and prior healthcare providers.

Refusal of psychiatric or psychological evaluation.

Forecasting negative medical outcomes despite no evidence.

The patient sabotaging discharge plans or suddenly becoming more ill as they're about to be discharged from the hospital setting.

》People with factitious disorder may:

Lie about or mimic symptoms.

Hurt themselves to bring on symptoms.

Alter diagnostic tests (such as contaminating a urine sample or tampering with a wound to prevent healing)

Be willing to undergo painful or risky tests and operations in order to obtain the sympathy and special attention given to people who are truly medically ill.

》The exact cause of factitious disorder is not known, but researchers believe both biological and psychological factors play a role. Some theories suggest that a history of abuse or neglect as a child, or a history of frequent illnesses in themselves or family members that required hospitalization, may be factors in the development of the disorder.

》Most people with this condition do not believe they have factitious disorder. They may not be entirely aware of why they are inducing their own illness. Many people with factitious disorder may also suffer from other mental disorders, particularly personality or identity disorders.

》The first goal of treatment is to change the person's behavior and reduce their misuse of medical resources. In the case of factitious disorder imposed on another, the main goal is to ensure the safety and protection of any real or potential victims.

Once the first goal is met, treatment aims to resolve any underlying psychological issues that may be causing the behavior.
The primary treatment for factitious disorder is psychotherapy (a type of counseling).