Factitious disorder is a condition in which the patient consciously and deliberately acts as if they have a physical or mental illness when nothing is really wrong.

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 of creating visible symptoms, or alter medical evidence (e.g. a urine sample) so that they look sick.

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

They are usually people with emotional difficulties

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

In other words, these individuals often have long-lasting patterns of thought and behaviour that differ from what society considers normal . In addition, they also tend to have poor coping skills and serious problems in 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 do not relate to an actual illness. However, people with somatoform disorder don’t fake symptoms or mislead others , but think they have illnesses they don’t really have.

Characteristics of a person with Factitious Disorder

People with this disorder often have these characteristics:

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

Types of Factitious Disorders

Depending on the different symptoms, there are four types of factitious disorders:

Factitious disorder with mostly psychological symptoms

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

Factitious disorder with psychological and physical symptoms

People with this disorder claim to have symptoms of both physical and mental illness.

Factitious disorder not specified

This type includes a disorder called t factitious proxy disorder , also known 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 may 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 claim that these patients have suffered abuse or lack of affection during childhood that may be associated with serious 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 treatment of this disorder is to modify the patient’s behavior and to eliminate or reduce the misuse of medical resources . In the case of factitious proxy disorder, the primary goal is the protection of any potential victim.

Once these goals have been met, the next step is to understand the psychological reasons that are driving the patient’s behavior. The treatment par excellence is psychotherapy, preferably cognitive-behavioral therapy. In this way we act on the patient’s thinking and behavior.

Family therapy can also be useful so that family members do not reward the patient’s prejudicial behavior. In severe cases, antidepressant and anti-anxiety drugs are administered