About mental health: factitious disorders

What is mental health: factitious disorders?

Factitious disorders are conditions in which a person acts as if he or she has a physical or mental illness when he or she is not really sick. Factitious disorder by proxy is when a person acts as if a person in their care has an illness when they do not.

People with factitious disorders deliberately create or exaggerate symptoms of an illness in several ways. They may lie about or fake symptoms, hurt themselves to bring on symptoms, or alter tests (such as contaminating a urine sample) to make it look like they or the person in their care are sick.

People with factitious disorders behave this way because of an inner need to be seen as ill or injured, not to achieve a clear benefit, such as financial gain. People with factitious disorders are even willing and sometimes eager to undergo painful or risky tests and operations in order to obtain the sympathy and special attention given to people who are truly ill or have a loved one who is ill. Factitious disorders are considered mental illnesses because they are associated with severe emotional difficulties.

Many people with factitious disorders also suffer from other mental conditions, particularly personality disorders. People with personality disorders have long-standing patterns of thinking and acting that differ from what society considers usual or normal. These people generally also have poor coping skills and problems forming healthy relationships.

Factitious disorders are similar to another group of mental disorders called somatoform disorders, which also involve the presence of symptoms that are not due to actual physical or mental illnesses. The main difference between the two groups of disorders is that people with somatoform disorders do not fake symptoms or mislead others about their symptoms on purpose.

Types of Factitious Disorders

There are four main types of factitious disorders, including:

  • Factitious disorder with mostly psychological symptoms: As the description implies, people with this disorder mimic behavior that is typical of a mental illness, such as schizophrenia. They may appear confused, make absurd statements and report hallucinations, the experience of sensing things that are not there; for example, hearing voices. Ganser syndrome, sometimes called prison psychosis, is a factitious disorder that was first observed in prisoners. People with Ganser syndrome have short-term episodes of bizarre behavior similar to that shown by people with serious mental illnesses.
  • 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 sometimes referred to as Munchausen syndrome, named for Baron von Munchausen, an 18th century German officer who was known for embellishing the stories of his life and experiences.
  • Factitious disorder with both psychological and physical symptoms: People with this disorder produce symptoms of both physical and mental illness.
  • Factitious disorder not otherwise specified: This type includes a disorder called factitious disorder by proxy (also called Munchausen syndrome by proxy). People with this disorder produce or fabricate symptoms of illness in another person under their care. It most often occurs in mothers (although it can occur in fathers) who intentionally harm their children in order to receive attention.

What are the symptoms for mental health: factitious disorders?

Dramatic medical history symptom was found in the mental health: factitious disorders condition

Possible warning signs of factitious disorders include:

  • Dramatic but inconsistent medical history
  • Unclear symptoms that are not controllable and that 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 with others or being observed
  • 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
  • Reluctance by the patient to allow health care professionals to meet with or talk to family members, friends, and prior doctors

What are the causes for mental health: factitious disorders?

The exact cause of factitious disorders is not known, but researchers are looking at the roles of biological and psychological factors in the development of these disorders. Some theories suggest that a history of abuse or neglect as a child, or a history of frequent illnesses that required hospitalization, might be factors in the development of the disorder.

What are the treatments for mental health: factitious disorders?

The first goal of treatment for a factitious disorder is to modify the person's behavior and reduce his or her misuse or overuse of medical resources. In the case of factitious disorder by proxy, the main goal is to ensure the safety and protection of any real or potential victims. Once the initial goal is met, treatment aims to work out any underlying psychological issues that may be causing the person's behavior.

The primary treatment for factitious disorders 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 may also be helpful in teaching family members not to reward or reinforce the behavior of the person with the disorder.

There are no medications to treat factitious disorders themselves. Medication may be used, however, to treat any related disorder -- such as depression, anxiety, or a personality disorder. The use of medications must be carefully monitored in people with factitious disorders due to the risk that the drugs may be used in a harmful way.

What are the risk factors for mental health: factitious disorders?

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 health care field

Factitious disorder is considered 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, and some are never identified — all of which make it difficult to get a reliable estimate.

Is there a cure/medications for mental health: factitious disorders?

Medications may be used to treat additional mental health disorders, such as depression or anxiety.

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