What Is Factitious Disorder?
Factitious disorder is a mental illness wherein the person suffering misleads or hoaxes others by portraying illness, intentionally getting sick, or by self-injuring themselves, including falsifying medical reports and tests to convince a medical professional to provide them with treatment, including surgeries (unwanted). Chances of getting a factitious disorder are high when family members or others (including relatives and caregivers) falsely present the person or the child as ill, injured, or impaired.
Factitious disorders are conditions in which a person deliberately and consciously acts as if they are suffering from a physical or mental illness when in reality, they are not. There is a difference between people who tamper with medical reports and those who are suffering from a factitious disorder. People who tamper with medical reports do so for their practical or financial benefit. On the other hand, people suffering from Munchausen syndrome understand that they are using falsified disorders for their benefit, but do not understand the reason behind their behavior, or even realize that they are suffering from a disorder.
People suffering from this disorder deliberately create and exaggerate symptoms of an illness in several different ways. Individuals with factitious disorders behave in a certain way because of an inner need to be seen or to gain attention as being ill or injured. Factitious disorder is considered a mental illness because it is associated with serious emotional difficulties. Factitious disorder or Munchausen syndrome by proxy is a condition where a caregiver behaves as though a person in their care is suffering from an illness when they are not.
What Are the Types of Factitious Disorder?
The Factitious disorder can be divided into four categories-
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Factitious Disorder With Psychological Symptoms: As the name suggests, people suffering from a factitious disorder involving only psychological symptoms mimic behavior that is typical of a mental illness, such as schizophrenia or depression. The patient or sufferer appears confused, makes absurd statements, and complains of hallucinations and delusions or illusions; they experience things that are not really present.
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Factitious Disorder With Physical Symptoms: People suffering from this subtype of the disorder claim to be suffering from physical symptoms related to an illness, such as chest pain, stomachache, headache, body ache, or fever. This subtype is sometimes referred to as Munchausen syndrome, named after Baron von Munchausen (18th-century German officer), who was known to falsify stories and past life experiences.
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Factitious Disorder With Both Psychological And Physical Symptoms: People with this subtype attempt to show or portray symptoms of both physical and mental illnesses.
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Factitious Disorder Not Otherwise Specified: This subtype includes a disorder called factitious disorder by proxy, also called Munchausen syndrome by proxy. An individual suffering from this disorder fabricates symptoms of illness in another person under their care. Mothers are highly prone to be affected by this disorder; however, fathers are affected by it too. The person suffering intentionally harms their children in order to receive attention and care.
What Causes Factitious Disorder?
The exact cause of the factitious disorder is yet to be known. However, the disorder can be caused due to certain psychological factors individually or adjunct to each other.
Some of the probable causes of factitious disorder are:
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History of childhood trauma (including physical, emotional, sexual, or emotional abuse).
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Loss or death of a close one (including the death of a parent, caregiver, relative, or a close family member).
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Personality disorders.
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Low or no self-esteem.
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Depression.
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Association with a medical or healthcare department.
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Facing neglect as a child.
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Social rejection or isolation.
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Dysfunctional family.
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History of suffering from a chronic disease.
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History of hospitalization.
What Are the Symptoms of Factitious Disorder?
As mentioned earlier, a person suffering from a factitious disorder interprets being ill by tampering with medical documents or evidence to receive treatment for a disease they are not suffering from. People suffering from this disorder go to extreme lengths to get attention or to carry on with their lies. Individual suffering carries on with their deception irrespective of their benefit or whether or not they receive attention for it.
Other symptoms of the factitious disorder include:
1. Cunning forgery of medical reports.
2. Deep knowledge of medical terminology.
3. Vaguely present or completely absent symptoms.
4. The individual suffers from conditions that get worse without a logical explanation.
5. Continuous visits to different hospitals and doctors.
6. Difficulty accepting a formal diagnosis.
7. History of frequent hospitalization.
8. History of unwanted surgeries and surgical scars.
9. Aggressive behavior towards hospital staff and doctors.
10. Dramatic, inconsistent, and illogical medical history.
11. Presence of new symptoms without proper explanation.
12. Too eager or willing to get a medical test done.
What Is the Treatment for Factitious Disorder?
The treatment for factitious disorder mainly aims at making the person understand their situation, changing the person’s behavior, and reducing their misuse of medical resources. In certain situations, severe cases of factitious disorders can be fatal or life-threatening and prevent one from committing suicide or ending up dead. Once the aim of the treatment is achieved, the goal is then to move further to resolve the underlying psychological cause.
The primary treatment for factitious disorder is psychotherapy (also known as talk therapy). Treatment focuses on changing the person’s outlook and behavior towards the condition. Psychotherapy includes cognitive-behavioral therapy (CBT) and family therapy. Both cognitive-behavioral therapy and family therapy aim to talk to the patient and discuss their issues and conditions and for people to accept and correct the patient when they are wrong. Family therapy has proven to be accepting and fruitful when it comes to caring for someone suffering from a factitious disorder.
No true medicinal therapy has been prescribed by medical professionals for factitious disorders. However, selective serotonin reuptake inhibitors (SSRIs) help to manage the following:
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The underlying psychological causes and behaviors causing factitious disorder.
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Mood disorders.
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Anxiety disorders.
Antipsychotics have proven effective in treating the underlying causes of factitious disorders such as antisocial disorder or multiple personality disorder.
Monitoring is also an essential part of the treatment plan. Factitious disorder (especially by proxy) can be a fatal detrimental illness that has proven to be life-threatening to an individual's health. In case the individual is, in fact, causing true physical and psychological harm to oneself, they need to be monitored. Even hoax illnesses and injuries have proven to be dangerous, and hence monitoring by a family member or healthcare professional is essential.
What Are the Complications of Factitious Disorder?
People suffering from factitious disorders pretend to be sick and can go to great lengths to prove their lies to be true. They frequently suffer from other mental health illnesses. While a factitious disorder has no proven treatment plan, the severity of the disease can turn into complications that can be life-threatening.
Some of the complications of the factitious disorder are:
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Accidental injury or death.
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Severe health issues or conditions.
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Substance abuse or dependence (drugs or alcohol).
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Post-traumatic stress disorder (PTSD).
People with factitious disorders are at a greater risk for health problems often associated with self-harming by causing or manifesting symptoms. A complication of factitious disorder imposed on others is the abuse and potential death of the sufferer.
Conclusion:
Factitious disorder is a challenging mental health disorder to identify and treat. Often people suffering from factitious disorder suffer from an episode or two of brief to moderate symptoms. However, medicinal and psychiatric therapies are critical to prevent severe injuries and, in worst-case scenarios, even death caused by self-harm which is a typical feature of the disorder. Unfortunately, due to the low self-awareness of the disorder, people suffering from factitious disorder do not seek or follow treatment. Factitious disorder is a treatable condition only when an early diagnosis and treatment plan is made and set in action.
