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Factitious disorder is a psychiatric disorder in which a person intentionally falsifies symptoms of a physical or mental illness. These symptoms are fabricated for primary internal gain (i.e. unconscious need for empathy or attention). Patients with factitious disorder imposed on self typically have a history of healthcare exposure and a tendency to undergo risky procedures. Patients with factitious disorder imposed on another try to falsify symptoms in another individual, commonly a child or elderly person. A history of parental abuse or personality disorders is often seen in this patients. The treatment of factitious disorders is cognitive behavioral therapy.

10 KEY FACTS

Patients with this disorder intentionally falsify their symptoms. Contrast this with illness anxiety disorder in which symptoms are not intentionally produced.

Unlike malingering where the motivation is a type of secondary gain (e.g., skipping work), the motivation in patients with factitious disorder is primary gain, which is usually the need for sympathy and special treatment.

While symptoms are produced intentionally, the motivation for producing these symptoms is the unconscious need for special treatment and empathy.

Factitious disorder can be imposed on self or another. Factitious disorder imposed on self is a factitious disorder wherein patients feign disease to draw sympathy or reassurance to themselves.

Patients with factitious disorders usually have a history of significant healthcare exposure (e.g., being a nurse) and therefore have an unusual grasp of medical terminology.

These patients typically have a history of previous surgeries or costly procedures (e.g., multiple scans, biopsies, etc.). Thus, they can have multiple surgical scars and/or complications from invasive procedures.

In factitious disorder imposed on another, someone falsely claims that another person (e.g., child or elderly) has physical signs or symptoms of illness. In factitious disorder imposed on another, illness is fabricated or even caused by the caregiver.

History of parental abuse, psychological trauma, sexual and physical abuse are all associated with factitious disorder. Factitious disorder imposed on another is considered a type of child/elderly abuse.

Factitious disorders are associated with personality disorders, particularly borderline personality disorder, which is a type of cluster B personality disorder.

Cognitive behavioral therapy (CBT) can be an effective treatment for factitious disorder. CBT is a type of psychotherapy based on analyzing and reforming maladaptive thoughts that are contributing to emotional and behavioral distress.

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