Factitious Disorder

Factitious Disorder

Factitious Disorders are characterized by physical or psychological symptoms that are intentionally produced or feigned in order to assume the sick role. The judgment that a particular symptom is intentionally produced is made both by direct evidence and by excluding other causes of the symptom.

Factitious Disorders are distinguished from acts of Malingering. In Malingering, the individual also produces the symptoms intentionally but has a goal that is obviously recognizable when the environmental circumstances are known.

Features

The essential features concerning factitious disorder are:

1.     the intentional production of physical or psychological signs or symptoms

2.     The motivation for the behavior is to assume the sick role

3.     External incentives for the behavior (e.g., economic gain, avoiding legal responsibility, or improving physical well-being, as in Malingering) are absent.

Individuals with Factitious Disorder usually present their history with dramatic flair but are extremely vague and inconsistent when questioned in greater detail. They may engage in pathological lying, in the manner that is intriguing to the listener, about any aspect of their history or symptoms (i.e., pseudologia fantastica).

Symptoms

Factitious disorder signs and symptoms may include:

·   Extensive knowledge of medical terms and diseases

·   Clever and convincing medical or psychological problems

·   Vague or inconsistent symptoms

·   Conditions that get worse for no apparent reason

·   Conditions that don't respond as expected to standard therapies

·   Seeking treatment from many different doctors or hospitals, which may include using a fake name

·   Reluctance to allow doctors to talk to family or friends or to other health care professionals

·   Frequent stays in the hospital

·   Eagerness to have frequent testing or risky operations

·   Many surgical scars or evidence of numerous procedures

·   Having a few visitors when hospitalized

Treatment

People with factitious disorder may be well aware of the risk of injury or even death as a result of self-harm or the treatment they seek, but they can't control their behaviors and they're unlikely to seek help. Even when confronted with objective proof — such as a videotape — that they're causing their illness, they often deny it and refuse psychiatric help.