Figuring Out Factitious Disorder
You have a friend who is always sick. She appears to be very weak and spends a lot of time in bed. She claims to be cancer stricken but her doctor is very far away. You suspect that she has factitious disorder.
Factitious disorder is a serious mental disorder in which someone deceives others by appearing sick, by purposely getting sick, or by self-injury. Factitious disorder symptoms can range from a mild, slight exaggeration of symptoms to severe, which is previously called Munchausen syndrome.
The person may make up symptoms or even tamper with medical tests to convince others that treatment, such as high-risk surgery is needed. Factitious disorder is mysterious and hard to treat. Because people with factitious disorder want to be in the sick role, they’re often unwilling to seek treatment. However, if approached in a gentle, nonjudgmental way, a person with factitious disorder may agree to being treated by a mental health provider.
Factitious disorder is an illness that is feigned or faked for the purpose of being a patient. Actually you can think of this as a game of medicine. The person with the fake disorder that fits the category of factitious disorder is one who fakes an illness for the purpose of being a part of medicine, or the medical game.
The disorder can show physical symptoms or psychological symptoms. The physical symptoms can be a septic joint, which the individual produced themselves. It could be severe abdominal pain, which the person feigns in order to get medical attention.
The person with factitious disorder can then get the medical attention that fulfills their need to play the game of medicine. In the case of factitious disorder, illness can be imitated in multiple ways including confabulation, lying, faking of symptoms, ingestion of substances, injection of substances, tampering of specimens and so forth. Often, these people will reject any efforts to obtain prior medical records, which might show that they are feigning illness.
In cases of extreme limitations or the ability to produce the symptoms in one’s self, many people with factitious disorder actually will produce the symptoms in somebody else so they can be a rescuer and continue to play the game of medicine. Now, they can be on the other side helping the identified patient. This happens to be called Munchausen by proxy.
These are patients who will feign psychiatric symptoms for the purpose of being a patient, being in the hospital and being on the psychiatric unit.
They seem to be strongly attracted to the role of being a psychiatric patient. Every psychiatric symptom can be faked. It is much easier to fake psychiatric symptoms than physical symptoms. However, well-trained, experienced psychiatrists can pick up very quickly these are not typical psychiatric symptoms, but are fabricated.
There is a special type of factitious disorder referred to as Munchausen syndrome. This is the most dramatic stage of factitious disorder. It is characterized by the individual who usually feigns physical symptoms. They travel from hospital to hospital, city to city, seeking medical attention for a disease that is fake.
When it is realized that the individual doesn’t have an organic, physical illness and that is being faked or a feign illness, he or she will leave the hospital, usually in anger and with hostility toward the hospital and go directly to another hospital with similar symptoms to get into the role of patient at another hospital.
Treatment for factitious disorder can be very difficult. Some experts believe allowing the patient to “save face” and not confront them about faking it is the best course of action. The therapist must not be punitive or punish the patient in any way.
One of the best ways to deal with this is to have the patient undergo behavioral therapy and possibly refer them to physical therapy if necessary. That way the patient is still in the medical game. But there is no standard treatment for factitious disorder.
