A factitious disorder is a mental illness in which a person makes up an illness or injury. The Diagnostic and Statistical Manual (DSM-IV) identifies four types of factitious disorders:
A factitious disorder may be confused with another type of mental disorder called somatoform disorder. If a person has somatoform disorder, then he or she is not pretending to be sick. The person really believes that there is something physically wrong. However, the symptoms are actually due to psychological issues. Hypochondria is an example of a somatoform disorder. Someone who has hypochondria fears that a real or imagined minor physical symptom is a sign of serious illness.
A factitious disorder is also different from malingering. Malingering occurs when a person is pretending to be sick for some kind of clear benefit, such as money, food, or housing.
The exact cause of factitious disorder not known. However, it may be a mixture of biological and psychological factors. Some possible causes may include:
These risk factors increase your chance of factitious disorder:
Symptoms may include:
It is difficult for a doctor to diagnosis a factitious disorder. People who have this disorder become very skillful in pretending to have illnesses. The doctor also has to rule out any real physical condition that the person may have.
If the doctor determines that there is no physical cause for the symptoms, then the person may be referred to a mental health expert. This expert can then rule out other psychological conditions, like somatoform disorder and malingering. The person may become hostile and not want to work with a psychologist. However, there are strategies that the doctor can use to act in a way that is more supportive and helpful. The patient can be encouraged to seek mental health treatment.
Factitious disorder is difficult to treat. The person may resist getting help. In some cases, though, the person may agree to work with a mental health expert. Psychotherapy or behavior therapy may be helpful. If the person has any other conditions, like depression, anxiety, or other mental health problems, these can be treated as well.
American Psychological Association
American Psychiatric Association
Canadian Psychiatric Association
Canadian Psychological Association
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Somatoform disorders. Merck website. Available at: http://www.merckmanuals.com/home/mental_health_disorders/somatoform_disorders/overview_of_somatoform_disorders.html?qt=&sc=&alt=. Updated June 2008. Accessed December 31, 2012.
Last reviewed March 2013 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.