Note: Some of the language featured in this article refers to gender dichotomously as that is what is indicated in the research, and it does not talk about any variability. We have used the language in the research because this is what was reported.
What is Factitious Disorder?
Factitious disorder is a severe mental health disorder. It is characterized by deceiving others by appearing sick, purposely getting sick, or intentionally injuring oneself. In addition, the factitious disorder can occur when family members or caregivers falsely portray others, most often their children, as being ill, injured, or disabled.
Factitious disorder is associated with extreme emotional difficulties. It is also known to have a high likelihood of someone harming themselves since they will continue to produce more symptoms. As a result, they undergo unnecessary procedures and surgeries.
What Are the Types of Factitious Disorders?
There are two types of Factitious disorders. These include:
- Factitious disorder imposed on self (formerly known as Munchausen syndrome)
This disorder includes falsifying psychological or physical signs or symptoms on themselves. For example, someone with a factitious disorder could pretend to have a severe illness like cancer, or a severe mental illness, like schizophrenia.
- Factitious disorder imposed on another (formerly known as Munchausen by proxy).
People with this type of Factitious disorder will produce or fabricate symptoms of illness in other people, most often under their care: for instance, children, elderly adults, disabled people, or pets. It commonly occurs in mothers; however, it can come from fathers. In essence, these caregivers will intentionally harm whoever is in their care so that they can receive attention. It is important to note that the diagnosis is given to the perpetrator and not the victim.
How Common Are Factitious Disorders?
Finding accurate statistics can be difficult when determining how common factitious disorders are. This is because of the dishonesty of the people who have this mental health condition. Also, people who have this disorder will find treatment at various healthcare facilities, creating misleading statistics.
However, a National Hospital Discharge Survey conducted in 2013 found 6.8 cases of a factitious disorder per 100,000 patients. Researchers also found that women who work in the healthcare community could have a factitious disorder and personality disorders like Borderline Personality Disorder (BPD) or histrionic personality traits or disorders.
What Are the Most Common Symptoms of Factitious Disorders?
Here are some potential warning signs of factitious disorders:
- An extremely dramatic but inconsistent medical history
- Vague symptoms that cannot be controlled and get more severe or change once the treatment has started.
- Predictable relapses after the condition improve.
- Extensive knowledge of hospitals and/or medical terminology and the textbook descriptions of illnesses.
- Having many surgical scars.
- New or additional symptoms emerge after negative test results.
- Symptoms only occur when the patient is with other people or being observed.
- Willingness or eagerness to have medical tests done and various procedures or surgeries.
- There is an extensive history of finding treatment at many hospitals and clinics or various doctors, sometimes in different cities.
- The person is reluctant to allow health care professionals to meet with their loved ones or other doctors.
What Are Some Complications of Factitious Disorders?
People with factitious disorders will risk their lives so that other people will view them as sick. They may have other mental health conditions and face extreme complications, like:
- Injury or death from self-inflicted medical issues
- Serious health problems resulting from infections or unnecessary procedures
- Loss of organs or limbs due to unneeded surgery
- Substance and/or alcohol abuse
- Difficulties in daily functioning and issues with relationships and work
- Inflicting abuse onto others (when it is a factitious disorder imposed on another)
What is the Cause of Factitious Disorders?
The exact cause of factitious disorders is not entirely known. However, researchers are studying the roles of biological and psychological factors that could lead to the development of these disorders. Some theories believe it could come from childhood trauma, like emotional, physical, or sexual abuse. However, it could also be due to a severe illness during childhood or losing a loved one through death, disease, or abandonment.
How Do Medical Professionals Diagnose Factitious Disorders?
Diagnosing factitious disorders can be a complicated process. Again, this is due to the amount of dishonesty involved. Doctors first will need to rule out another possible physical and mental health conditions before a diagnosis of factitious disorder can be considered.
Suppose the medical professional finds no physical reason for a person having these symptoms or suspects that abnormal laboratory results could be self-induced. In that case, they likely will refer the person to a psychiatrist or psychologist who specializes in these types of conditions.
Psychiatrists and psychologists will use assessment tools and interview skills to evaluate and diagnose a person with a factitious disorder. The doctor will base their diagnosis on the lack of having an actual physical or mental illness. They will also observe the person’s attitude and behaviors.
What is the Treatment for Factitious Disorders?
One of the first treatment goals for a factitious disorder imposed on oneself is to modify the person’s behavior to minimize their misuse or overuse of medical resources. When it comes to factitious disorder by proxy, the goal is to provide safety and protection for any victims. Once the first goal is established, treatment will help address any underlying psychological issues contributing to the person’s behavior.
The most effective treatment for factitious disorders is psychotherapy, a type of counseling. Family therapy can also help teach family members to stop rewarding or reinforcing the person’s behavior who has the disorder.
There are no medications that specifically treat factitious disorders; however, some medicines can be used to treat symptoms like depression and anxiety that can accompany factitious disorders. However, medications must be carefully monitored in people with factitious disorders if they decide to misuse these drugs to harm themselves.