Factitious Disorders: Symptoms, Causes and Treatment

What is a factitious disorder? Psychology explains it.

The factitious disorder is a condition in which the patient consciously and deliberately acts as if he/she has a physical or mental illness when nothing is really wrong with him/her.

Patients with this disorder create and exaggerate the symptomatology of an illness in a variety of ways. They may lie about their symptoms, harm themselves as a way of creating visible symptoms, or alter medical tests (e.g., a urine sample) so that they appear ill.

In fact, they are able to go through painful tests or risky operations to gain sympathy from people who pay attention to individuals who are actually sick.

They are usually people with emotional difficulties

This behavior is considered a disorder because it is associated with severe emotional difficulties. But, in addition, people suffering from this psychopathology often suffer from other mental health problems, such as personality disorders.

In other words, these individuals often have long-standing patterns of thought and behavior that differ from what society considers normal.. In addition, they also often have poor coping skills and serious problems relating to others.

Differential Diagnosis Between Factitious Disorder and Somatoform Disorder

Factitious disorder is similar to another psychopathology that goes by the name of somatoform disorderwhich also includes the presence of symptoms that have nothing to do with an actual illness. However, people with somatoform disorder do not fake symptoms or deceive others, but think they have illnesses that are not related to a real disease.They think they have diseases that they do not really have.

Characteristics of a person with Factitious Disorder

People with this disorder often exhibit these characteristics:

• Dramatic but inconsistent medical history.
• Unclear symptoms that are not controllable and that become more severe or change once treatment has begun
• Predictable relapses after improvement of the disease
• Presence of many scars
• The appearance of new or additional symptoms following negative medical or psychological test results
• Presence of symptoms only when the patient is with others or is being observed
• Desire for tests or operations
• Reluctance on the part of the patient to allow health care professionals to speak with family members, friends, and previous physicians

Types of Factitious Disorders

Depending on the different symptomatology, there are four types of factitious disorders:

Factitious disorder with mostly psychological symptoms.

Individuals with this psychopathology mimic the typical symptoms of schizophrenic disorder. Thus, they often simulate confusion, make absurd statements and claim to have hallucinations or delusions; for example, hearing voices.

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 also known as Munchausen's syndrome.

Factitious disorder with psychological and physical symptoms.

People with this disorder report having symptoms of both physical and mental illnesses.

Factitious disorder not otherwise specified

This type includes a disorder called tfactitious disorder by proxyalso known as Munchausen syndrome by proxy. People with this disorder invent the symptoms of the disease in another person under their care. It occurs most often in mothers (although it can occur in fathers) who intentionally harm their children in order to receive attention.

Causes of Factitious Disorder

The exact causes of factitious disorder are not known, but researchers believe it is due to biological and psychological factors..

Some theories state that these patients have suffered abuse or lack of affection during childhood that may be associated with serious emotional problems, as well as a medical history characterized by frequent illnesses requiring hospitalization.

Studies suggest that this condition is more common in men than in women. In contrast, factitious disorder by proxy is more common in women.

Treatment of Factitious Disorder

The most important goal of the treatment of this disorder is to to modify patient behavior and eliminate or reduce the misuse of medical resources.. In the case of factitious proxy disorder, the primary goal is the protection of any potential victims.

Once these goals have been met, the next step is to understand the psychological reasons that are driving the patient's behavior. The treatment par excellence is psychotherapy, preferably cognitive-behavioral therapy. In this way, the patient's thinking and behavior are acted upon.

Family therapy can also be of use so that family members do not reward the patient's prejudicial behavior. In severe cases, Antidepressant and anxiolytic drugs are administered.