What are Factitious Disorders?
“Factitious” comes from the Latin word meaning “artificial,” and as the name suggests, people with factitious disorders will present artificial symptoms of real medical conditions. They will often go to incredible lengths to imitate symptoms of a real medical condition. In some cases, people with factitious disorders have intentionally harmed themselves, injected bacteria into their bodies, contaminated lab tests, and taken hallucinogenic drugs to feign symptoms. People with factitious disorders are often hospitalized and will even undergo unpleasant or painful medical tests in order to further their lies.
Factitious disorders are similar to hypochondriasis in that the symptoms or complaints are not from tangible medical conditions. However, there is one key difference between factitious disorders and hypochondriasis: people with hypochondriasis believe that they are ill whereas people with factitious disorders do not.
What are the types of factitious disorders?
How prevalent are factitious disorders?
It is incredibly difficult to get an accurate depiction of how prevalent factitious disorders are. This is because many people with factitious disorders are very masterful at faking their symptoms. In one year-long study of patients in a Berlin hospital, it was shown that approximately .3% of hospitalized patients had a factitious disorder. This study shows that factitious disorders may be much more common than previously thought.
What are the characteristics of factitious disorders?
For a factitious disorder to be diagnosed it requires that these criteria be met:
The criteria for diagnosing a factitious disorder by proxy include:
Diagnosing Factitious Disorders
It can be very difficult to identify factitious disorders because the perpetrators are often very adept in feigning symptoms or may even go to great lengths to physically cause symptoms. In one case, a woman was admitted to a hospital complaining about hematamesis and insisted on receiving surgery. When an endoscopy did not show any stomach bleeding, the woman shoved her fingers up her nose to make it bleed down her throat.
Since people with factitious disorders can be very persistent, physicians must carefully monitor for people with the disorder. A physician will need to:
If a physician suspects that a factitious disorder is present, he/she may need to contact law enforcement.
What causes factitious disorders?
Experts have not identified one solid cause of factitious disorders. Most likely, factitious disorders are caused from a combination of emotional aspects. Some experts believe that people with factitious disorders suffer from a sense of inadequacy or unstable self worth. They then use the factitious behaviors to get attention and sympathy so define their self worth.
Factitious disorders could also be linked to a history of hospitalization or sickness during childhood. Then, the patient tries to recreate this state in order to return to normalization. Another possible cause of factitious disorders is that someone close to the person really was chronically ill. Thus, the person became jealous of the attention and began to feign symptoms in order to get attention.
How are factitious disorders treated?
People with factitious disorders will almost always insist that their symptoms are real, despite medical evidence to the contrary. This makes factitious disorders incredibly difficult to treat and most patients will refuse any sort of treatment.
The initial goal of treatment is to prevent the person from abusing the medical system or another person in Munchausen by proxy. After these goals are met, then treatment of the disorder can begin. Typically, factitious disorders will be treated with counseling such as family therapy. During family therapy, the family members will be made aware of the condition and taught not to reward the factitious behaviors. Antidepressants may also be effective in treating factitious disorders but it is important that someone ensures the patient is actually taking the medicine properly.
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