Factitious Disorder

10 Minutes

Edited & medically reviewed by THE BALANCE Team

Fact checked

CONTENTS

Factitious disorder is a complex mental illness in which a person deceives people by pretending to be unwell, getting sick deliberately, or injuring themselves. Members of the family or caretakers can also cause factitious disorder by fraudulently portraying others, like children, as injured, ill, or disabled.

Features of the factitious condition can range from moderate (some exaggeration of complaints) to severe, formerly called Munchausen syndrome (full exaggeration of symptomatology). To persuade others that medical treatment, like high-risk surgery, is required, the person may fabricate symptoms or even interfere with medical tests. Devising medical difficulties for the purpose of getting out of a job or trying to win a lawsuit is not the same as factitious disorder.

You might be wondering how Munchausen syndrome differs from a factitious disorder if you’ve heard the word. The simple answer is that Munchausen syndrome is a type of factitious condition, albeit many healthcare practitioners confuse the two categories.

Munchausen syndrome is an appropriate medical term for a factitious condition that includes the following:

Symptoms that are mostly physical
A series of feigned illnesses and injuries

This ancient name derives from German Cavalry commander Karl Frederick Hieronymus, Frieherr Von Munchausen, who spun strange tales about his adventures.

It’s difficult to diagnose and manage factitious disorders. However, medical and mental health assistance is essential for averting major injuries and even death from self-harm, which is a common adverse outcome of this disorder.

Factitious disorder is notoriously difficult to diagnose. Individuals with factitious disorders are masters of impersonating a wide range of disorders and ailments. And, despite the fact that these conditions are typically self-inflicted, people frequently have genuine or even life-threatening medical problems.

Obtaining information regarding previous medical experiences may be difficult or impossible due to the person’s usage of many doctors and hospitals, the use of a false name, and confidentiality and privacy restrictions.

While individuals with factitious disorder are aware that they are the source of their illnesses or symptoms, they may still not comprehend why they behave in the way they do or acknowledge that they have a problem.

The diagnosis is made on objectively recognizing made-up symptoms rather than the person’s aim or motivation. When a doctor suspects factitious disorder, it’s because:

The medical history of the individual does not make sense.
There is no plausible explanation for a sickness or injury.
The condition does not progress as expected.
Despite proper treatment, there remains a lack of recovery for no obvious reason.
There are signs or lab test findings that are conflicting or unclear.
The individual is adamant about not collecting information from past health records, other healthcare professionals, or close relatives.
The individual is caught red-handed for lying or injuring someone.

Furthermore, the diagnosis of factitious disorder is based on four main criteria. These are the following:

Falsification or induction of psychological or physical symptoms with the intent to deceive.
To others, the person appears to be unwell, disabled or damaged.
Even in the absence of any external rewards or incentives, deceitful behavior persists.
Another mental illness does not describe the behavior any better.

A single episode of factitious disorder or recurring episodes (2 or more occurrences of sickness fabrication and/or manipulation of injury) can be identified.

Doctors can use the following criteria to identify if someone has factitious disorder:

Undergo a comprehensive interview.
Need medical records from the past.
If the patient allows permission, work with family and friends to get further information.
Only run the tests that are required to resolve any potential physical issues.
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has criteria for a factitious disorder.

Confronting your spouse or partner, colleague, or close relative about their behavior if you suspect they are lying about a physical or mental health condition is unlikely to help.

Remember that Munchausen syndrome and factitious disorder is a psychiatric illnesses. They may not be aware of their motivations for fabricating these symptoms or feel unable to quit. Offering love and empathy without endorsing the conduct and urging them to get therapeutic help is usually the best approach.

You could try:

Urging them to seek help from a therapist if their symptoms are causing them any distress
Asking about their hobbies, work, or pets rather than their health issues
Providing encouragement through nice words and actions, or suggesting activities to attempt together
advising that you and your partner go to therapy to work on enhancing your communication and relational health.

If you feel a close one has rendered you, your kid, or another person ill, you should:

Seek medical assistance for the person who is sick or injured
If needed, find a safe place to stay
Communicate with a lawyer or other advocate for advice on what to do next.

When it comes to kids with factitious disorder, however, some data suggest that immediately addressing the behavior can help reduce the likelihood that your child will continue to lie regarding their symptoms. A psychotherapist who focuses on dealing with kids can assist in identifying and addressing the causes of the behavior.

Factitious disorder is hard to treat, and there are no proven treatments. Individuals with factitious disorders are usually reluctant to pursue or accept therapy because they wish to play the sick role. An individual with a factitious disorder may accept to be helped by a mental health expert if approached in a friendly, non-judgmental manner.

A Nonjudgmental Approach Is Essential

Direct allegations of factitious disorder often make the person in question furious and defensive, prompting him or her to terminate an engagement with a hospital or doctor and receive therapy elsewhere. As a result, the doctor may try to find an “exit” that will save your loved one the embarrassment of confessing to faking symptoms while yet providing information and assistance.

For instance, the clinician might assure your dear one that just not finding a reason for clinical symptoms is stressful, and that stress could be the cause for some physical ailments. Alternatively, the therapist may urge your cherished one to agree that when the next medical care fails, they would discuss the possibility of a mental component for the condition.

In either case, the clinician will try to direct your close one to a mental health specialist for treatment. Professionals and dear ones can both support healthy productive activities without overemphasizing symptoms and limitations.

Options For Treatment

Rather than attempting to cure the problem, factitious disorder treatment frequently focuses on controlling it. The following are common methods to devise a comprehensive factitious disorder treatment plan:

The importance of having a general practitioner or primary care physician. Having a single doctor or other intermediary medical experts oversee medical treatment can help to manage needed treatment and care programs while also reducing or eliminating visits to several physicians, therapists and specialists.

Psychotherapy. Talk therapy (psychotherapy) or counseling and behavior therapy can both aid with stress management and coping skills development. Family counseling may be considered if it is possible. Other mental health issues, such as depression, might be addressed as well.

Medication. Further mental health conditions, like anxiety or depression, may be treated with medications.

Hospitalization. A short stay in a mental clinic or psychiatric facility may be required for safety and treatment in severe instances.

Treatment may be refused or ineffective, particularly for those with severe factitious conditions.

The goal in these circumstances might be to prevent more invasive or dangerous therapies. When the factitious disorder is forced on others, the doctor looks for signs of abuse and, if necessary, reports the abuse to the proper authorities.

Home Remedies And A Healthy Lifestyle

These suggestions, in addition to professional treatment for a factitious disorder, may be beneficial to those with factitious disorders:

Follow your treatment regimen to the letter. Keep all of your treatment appointments and take all of your meds as prescribed. If you feel compelled to injure yourself or become unwell, speak openly with your therapist or primary care physician about other strategies to cope with emotions.

Having a medical gatekeeper is a wise idea. Instead of visiting several doctors, experts, and hospitals, have one trustworthy primary care provider oversee your medical treatment.

Keep the dangers in mind. Tell yourself that every time you injure yourself or have an unnecessary dangerous test or procedure, you risk long-lasting injury or even death.

Do not flee. Resist the impulse to change doctors or relocate to a new place where medical experts are unfamiliar with your history. Your therapist can assist you in overcoming these strong desires.

Make friendships and develop acquaintances. Many individuals who suffer from the factitious disorder have limited relationships or friendships and other forms of social interaction. Find someone with whom you can confide, share good times, and offer your own support.

When a doctor suspects that psychological difficulties are playing a role in the sickness, an individual with a factitious disorder is likely to seek treatment.

If your dear one is experiencing symptoms that could indicate a factitious condition, his or her therapist may contact you ahead of time — with the person’s permission — to discuss his or her medical history.

You proactively seek treatment for many ailments if you have Munchausen syndrome, but you are usually afraid to acknowledge and seek therapy for the condition itself. This complicates treating this illness, and the prognosis for recovery is bleak. It may be beneficial if caregivers can prevent you from self-harm and teach you about the potential effects. It’s also a good idea to try to limit your care to just one or two doctors who work closely together (internist or psychiatrist, for instance).

When seeking treatment, the first step is to change your behavior and limit your need for healthcare resources.

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Once this goal is achieved, counseling will focus on addressing any underlying mental health issues that may be influencing your behavior, as well as assisting you in addressing other social requirements.

Psychotherapy is the most common treatment for Munchausen syndrome (a type of counseling). The focus of treatment will be on improving your mindset and behavior (cognitive-behavioral therapy). Family therapy may also be beneficial in educating your close members of the family about Munchausen Syndrome. Group therapy may help you feel less alone or as if no one cares about you. Antidepressants and antipsychotic medicines aren’t known to assist.

FAQs

What Factors Put You At Risk For Factitious Disorder?

The following are some of the possible risk factors:
Age. According to a 2006 study, adults between the ages of 20 and 40 are more likely to have this condition.
Gender. Women are more likely than men to have a factitious disorder. However, some data suggest that men are more likely to suffer from chronic factitious conditions, often known as Munchausen syndrome.
Occupation. People who have this condition are often related to the healthcare or medical fields.
Relationship status. Single people are much more likely to have this problem.

What Are The Mental And Physical Health Complications Associated With Munchausen Syndrome And/or Factitious Disorder?

You are putting yourself in danger for medical issues (or even death) if you injure yourself or cause illness in any other way. Furthermore, you may experience adverse responses or health issues as a result of repeated tests, medical procedures, and therapies, and you are at significant risk of suicide attempts and substance abuse.

What Is The Outlook (Prognosis) For Those Suffering From Factitious Disorder?

It’s possible that you will only have one episode of symptoms. Nevertheless, in the vast majority of cases, the illness is a recurrent illness that can be hard to treat. You may dispute that you are faking symptoms and refuse to obtain or follow treatment.
Even with treatment, working toward controlling the disease rather than attempting to cure it is more practical. It is critical to avoid inappropriate or unnecessary hospitalizations, medical testing, or treatment.

HOW THE BALANCE CAN HELP WITH Mental Health

The Balance RehabClinic is a leading provider of luxury addiction and mental health treatment for affluent individuals and their families, offering a blend of innovative science and holistic methods with unparalleled individualised care.

Factitious Disorder

Home Remedies And A Healthy Lifestyle

FAQs

What Factors Put You At Risk For Factitious Disorder?

What Are The Mental And Physical Health Complications Associated With Munchausen Syndrome And/or Factitious Disorder?

What Is The Outlook (Prognosis) For Those Suffering From Factitious Disorder?

HOW THE BALANCE CAN HELP WITH Mental Health

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Factitious Disorder