Factitious Disorder

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The Factitious Disorder:

Factitious Disorder

Definition:

Factitious disorder is a condition in which a person deliberately and consciously acts as if he or she has a physical or mental illness when he or she is not really sick. [4]

Overview

  • The term factitious disorder refers to the intentional production of physical pathology or the feigning of physical or psychological symptoms, with the apparent aim of being diagnose as ill. [1]
  • It is a serious mental disorder in which someone deceives others by appearing sick, by purposely getting sick or by self-injury.
  • Factitious disorder also can happen when family members or caregivers falsely present others, such as children, as being ill, injure or impair.
  • Factitious disorder symptoms can range from mild (slight exaggeration of symptoms) to severe (previously called Munchausen syndrome).
Other key points
  • The person may make up symptoms or even tamper with medical tests to convince others that treatment, such as high-risk surgery, is need.
  • Although people with factitious disorder know they are causing their symptoms or illnesses, they may not understand the reasons for their behaviors or recognize themselves as having a problem.
  • Factitious disorder is challenging to identify and hard to treat. However, medical and psychiatric help are critical for preventing serious injury and even death cause by the self-harm typical of this disorder. [2]
  • Factitious disorder differs from malingering in that it does not bring any external reward such as avoidance of military or other occupational duties, or financial compensation. [1]

Sign & Symptoms

  • Dramatic but inconsistent medical history
  • Unclear symptoms that are not controllable, become more severe, or change once treatment has begun
  • Predictable relapses following improvement in the condition
  • Extensive knowledge of hospitals and/or medical terminology, as well as the textbook descriptions of illness
  • Presence of many surgical scars
  • Appearance of new or additional symptoms following negative test results
  • Presence of symptoms only when the patient is alone or not being observe
  • Willingness or eagerness to have medical tests, operations, or other procedures
  • History of seeking treatment at many hospitals, clinics, and doctors’ offices, possibly even in different cities
Other symptoms:
  • Reluctance by the patient to allow healthcare professionals to meet with or talk to family members, friends, and prior healthcare providers
  • Refusal of psychiatric or psychological evaluation
  • Forecasting negative medical outcomes despite no evidence of this
  • Sabotaging discharge plans or suddenly becoming more ill as one is about to be discharged from the hospital setting [3]

The cause of factitious disorder is unknown. However, the disorder may cause by a combination of psychological factors and stressful life experiences.

Risk factors:

Several factors may increase the risk of developing factitious disorder, including:

  • Childhood trauma, such as emotional, physical or sexual abuse
  • A serious illness during childhood
  • Loss of a loved one through death, illness or abandonment
  • Past experiences during a time of sickness and the attention it brought
  • A poor sense of identity or self-esteem
  • Personality disorders
  • Depression
  • Desire to be associated with doctors or medical centers
  • Work in the healthcare field

Factitious disorder is consider rare, but it’s not known how many people have the disorder.

Some people use fake names to avoid detection, some visit many different hospitals and doctors, also some are never identify all of which make it difficult to get a reliable estimate. [2]

Diagnosis

Generally, Diagnosing factitious disorder is often extremely difficult.

In detai; People with factitious disorder are experts at faking many different diseases and conditions.

And often they do have real and even life-threatening medical conditions, even though these conditions may be self-inflicted.

The person’s use of multiple doctors and hospitals, the use of a fake name, and privacy and confidentiality regulations may make gathering information about previous medical experiences difficult or even impossible.

Diagnosis is based on objectively identifying symptoms that are made up, rather than the person’s intent or motivation for doing so.

A doctor may suspect factitious disorder when:
  • The person’s medical history doesn’t make sense
  • No believable reason exists for an illness or injury
  • The illness does not follow the usual course
  • There is a lack of healing for no apparent reason, despite appropriate treatment
  • There are contradictory or inconsistent symptoms or lab test results
  • The person resists getting information from previous medical records, other health care professionals or family members
  • The person is caught in the act of lying or causing an injury

Physician may use the criteria for factitious disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. [2]

Treatment often focuses on managing the condition, rather than trying to cure it.

Treatment generally includes:

Having a primary care doctor i.e.:
  • Using one doctor or gatekeeper to oversee medical care can help manage needed care and the treatment plan and reduce or eliminate visits to numerous doctors, specialists and surgeons.
Psychotherapy i.e.:
  • Talk therapy (psychotherapy) and behavior therapy may help control stress and develop coping skills.
  • If possible, family therapy also may be suggested.
  • Other mental health disorders, such as depression, also may be addressed.
Medication i.e.:
  • Medications may be used to treat additional mental health disorders, such as depression or anxiety.
Hospitalization i.e.:
  • In severe cases, a temporary stay in a psychiatric hospital may be necessary for safety and treatment.
Connect with someone i.e.:
  • Many people with factitious disorder lack friendships and other relationships.
  • Try to find someone you’re able to confide in, share enjoyable times with and offer your own support to.

Treatment may not be accepted or may not be helpful, especially for people with severe factitious disorder.

In cases where the factitious disorder is imposed on others, the doctor assesses for abuse also reports the abuse to the appropriate authorities, if indicated. [2]

Remedies for Factitious Disorder:

Tarentula Hispanica:
  • It is one of the most important remedy for factitious disorder.
  • It has fearfulness, especially when out of her usual surrounding of impending calamity.
  • Because of this fear it develops the symptoms of pretending and seek attention.
  • Pretends to be sick.
  • Faints in front of everyone.
  • Fear of being assaulted.
  • Profound grief and anxiety, anguish, melancholy profound with quick change of mood and becomes cheerful.
Veratrum album:
  • Melancholy, with stupor and mania.
  • Sits in a stupid manner.
  • Always wants to escape from work.
  • Aimless wandering at home.
  • It is one of the strongest remedies for malingering.
  • Puerperal mania.
  • Pretends to be pregnant.
  • Delusions of impending misfortune.
  • Frenzy of excitement and curses everyone.
  • Attacks of pain, with delirium driving to madness.
  • Cursing howling at night.
Other indicated remedies are:
  • Moschus
  • Silica
  • Argentum Nitricum
  • Belladonna
  • Ignatia
  • Plumbum
  • Sabadilla [5]

Frequently Asked Questions

What is Factitious Disorder?

Factitious disorder is a condition in which a person deliberately and consciously acts as if he or she has a physical or mental illness when he or she is not really sick.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Factitious Disorder?

  • Tarentula Hispanica
  • Veratrum album
  • Moschus
  • Silica
  • Argentum Nitricum
  • Belladonna
  • Ignatia
  • Plumbum

What causes Factitious Disorder?

  • Childhood trauma
  • A serious illness during childhood
  • Loss of a loved one through death, illness or abandonment
  • Past experiences during a time of sickness and the attention it brought
  • A poor sense of identity or self-esteem
  • Personality disorders
  • Depression
  • Desire to be associated with doctors or medical centers
  • Work in the healthcare field

What are the symptoms of Factitious Disorder?

  • Dramatic but inconsistent medical history
  • Unclear symptoms
  • Predictable relapses
  • Extensive knowledge of hospitals and/or medical terminology
  • Presence of many surgical scars
  • Presence of symptoms only when the patient is alone or not being observe
  1. Psychiatry, Fourth Edition- Oxford Medical Publications – SRG- by Geddes, Jonathan Price, Rebecca McKnight / Ch 25.
  2. https://www.mayoclinic.org/diseases-conditions/factitious-disorder/symptoms-causes/syc-20356028
  3. https://my.clevelandclinic.org/health/diseases/9832-an-overview-of-factitious-disorders
  4. https://www.webmd.com/mental-health/factitious-disorders#1
  5. Homeopathy in treatment of Psychological Disorders by Shilpa Harwani / Ch 10.
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