Factitious disorder is a mental disorder in which a person acts as if they have a physical or psychological illness when they themselves have created the symptoms. People with this disorder are willing to undergo painful or risky tests to get sympathy and special attention.
Factitious disorder is a serious mental health disorder in which a person appears sick or produces physical or mental illness. People with factitious disorder deliberately produce symptoms of an illness for the purpose of receiving care and attention in a medical setting. The symptoms aren’t intended to get them practical benefits — the gain is believed to be mainly psychological.
Factitious disorder is considered a mental illness. It’s associated with severe emotional difficulties and patients’ likelihood of harming themselves by continuing to produce more symptoms, resulting in getting themselves unnecessary procedures and surgeries.
Factitious disorders are of two types:
Possible warning signs of factitious disorder include:
No reliable statistics are available regarding the number of people in the United States who suffer from factitious disorder. Getting accurate statistics is difficult because patients don’t typically acknowledge their disorder. People with factitious disorders also tend to seek treatment at many different healthcare facilities, resulting in statistics that are misleading. It’s estimated that about 1% of those admitted to hospitals are believed to have factitious disorder, but this is likely under-reported.
The exact cause of factitious disorder is not known, but researchers believe both biological and psychological factors play a role. Some theories suggest that a history of abuse or neglect as a child, or a history of frequent illnesses in themselves or family members that required hospitalization, may be factors in the development of the disorder.
Most patients with factitious disorder have histories of abuse, trauma, family dysfunction, social isolation, early chronic medical illness or professional experience in healthcare (training in nursing, health aid work, etc.).
People with factitious disorder may:
Most people with this condition do not believe they have factitious disorder. They may not be entirely aware of why they are inducing their own illness. Many people with factitious disorder may also suffer from other mental disorders, particularly personality or identity disorders.
Due to the deceptive behaviors involved, diagnosing factitious disorder is difficult. Doctors must also rule out any possible physical and mental illnesses, and often use a variety of diagnostic tests and procedures before considering a diagnosis of factitious disorder.
If the healthcare provider finds no physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist (mental health professionals who are specially trained to diagnose and treat mental illnesses). Psychiatrists and psychologists use thorough history, physical examinations, laboratory tests, imagery, and psychological testing to evaluate a person for physical and mental conditions.
The doctor bases a diagnosis on the exclusion of actual physical or mental illness, and observation of the patient’s attitude and behavior.
The first goal of treatment is to change the person’s behavior and reduce their misuse of medical resources. In the case of factitious disorder imposed on another, the main goal is to ensure the safety and protection of any real or potential victims.
Once the first goal is met, treatment aims to resolve any underlying psychological issues that may be causing the behavior.
The primary treatment for factitious disorder is psychotherapy (a type of counseling). Treatment likely will focus on changing the thinking and behavior of the individual with the disorder (cognitive-behavioral therapy). Family therapy also may help in teaching family members not to reward or reinforce the behavior of the person with the disorder.
There are no medications to actually treat factitious disorder. Medication may be used, however, to treat any related disorder, such as depression or anxiety.
People with factitious disorder are at risk for health problems associated with hurting themselves by causing symptoms. In addition, they may suffer health problems related to multiple tests, procedures, and treatments, and are at high risk for substance abuse and suicide attempts. A complication of factitious disorder imposed on another is the abuse and potential death of the victims.
There is no known way to prevent factitious disorder. It may be helpful to start treatment in people as soon as they begin to have symptoms.
Some people with factitious disorder suffer one or two brief episodes of symptoms. In most cases, however, factitious disorder is a chronic, or long-term, condition that can be very difficult to treat. And unfortunately, due to their low self-awareness, many people with factitious disorder will not seek or follow treatment.
Last reviewed by a Cleveland Clinic medical professional on 12/03/2020.
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