Factitious Disorders: Symptoms, Causes, and Treatment

The factitious disorder it is a condition in which the patient consciously and deliberately acts as if he has a physical or mental illness when nothing is really happening to him.

Patients with this disorder create and exaggerate the symptoms of a disease in different ways. They may lie about their symptoms, hurt themselves as a way to create visible symptoms, or alter medical tests (for example, a urine sample) so that they appear sick.

In fact, they are capable of undergoing painful tests or risky operations to gain the sympathy of people who care for individuals who are truly ill.

They are usually people with emotional difficulties

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

That is, these individuals they tend to have long-lasting patterns of thought and behavior that differ from what society considers normal

. In addition, they also tend to 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 called somatoform disorder, which also includes the presence of symptoms that have nothing to do with a real disease. However, people with somatoform disorder do not fake symptoms or deceive othersInstead, they think they have diseases that they don't really have.

Characteristics of a person with Factitious Disorder

People with this disorder usually have these characteristics:

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

Types of Factual Disorders

According to the different symptoms, there are four types of fictitious disorders:

Factitious disorder with mostly psychological symptoms

Individuals with this psychopathology mimic the typical symptoms of schizophrenic disorder. Therefore, 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 report symptoms related to a physical illness, such as symptoms of chest pain, stomach problems, or fever. This disorder is also known as Munchausen syndrome.

Factitious disorder with psychological and physical symptoms

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

Unspecified factitious disorder

This type includes a disorder called tfactitious tracking by proxy, also know as Munchausen syndrome by proxy. People with this disorder make up 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 care.

Causes of Factitious Disorder

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

Some theories affirm that these patients have suffered abuse or lack of affection during childhood that can have serious associated emotional problems, as well as a medical history characterized by the frequent presence of diseases that require 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 treating this disorder is modify patient behavior and eliminate or reduce the misuse of medical resources. In the case of factitious disorder by proxy, the primary objective is the protection of any potential victim.

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

Family therapy can also be helpful so that family members do not reward the patient's harmful behavior. In severe cases, antidepressant and anxiolytic drugs are given