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A Condition not Commonly Known— Factitious Disorder

separator There are a few mental illnesses and disorders you’ve probably heard or read about at some time or another—depression, attention deficit disorder, phobias, anxiety attacks, etc. But many people haven’t heard of factitious disorder or factitious disorder by proxy. 

Factitious disorder—Patients intentionally produce symptoms of medical or mental disorders and lie about their medical histories or symptoms. They do this solely because they want to be patients, and for many of them, hospitalization is their main goal. Many of these people travel from one place to another and seek hospital admission under different names. At times, they seek out painful procedures, such as operations and invasive tests.

Many of these people suffered from childhood abuse that resulted in frequent hospitalizations. The childhood hospital stay may have provided more comfort than the home environment. Another reason they may have for pretending to be sick is simply to get attention and nurturing that they can’t seem to get any other way. People with factitious disorders are generally not looking for any financial gain, nor are they trying to get out of work. Those who pretend to be sick simply to get disability payments or other financial benefits, or who are trying to avoid work, are called “malingerers.”

When a patient with factitious disorder makes up mostly physical symptoms, the disorder is often called Munchausen syndrome.

Factitious disorder by proxy (also known as Munchausen syndrome by proxy)—Patients intentionally produce signs of illness in someone who is under their care. The most common instances are a mother who causes healthcare providers to believe her child is sick. In cases like this, the mother will create a false medical history, tamper with laboratory samples, change medical records or actually cause injury or illness in her child.

Obviously, patients with factitious disorders are rarely able to lead productive, “normal” lives. Frequent hospitalization makes it nearly impossible to form meaningful relationships or to earn a living. And of course, constant, unnecessary medical treatment is harmful to one’s health.

According to some research, there’s a nine percent rate of factitious disorders among all patients admitted to a hospital. Mental health professionals have been unable to identify an effective treatment plan for these patients. Frequently, as soon as the healthcare provider realizes that the patient is seeking unnecessary treatment, the patient will simply leave the hospital or fail to keep appointments.

The American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Washington, D.C., 2000; H. Kaplan, B. Sadock, J. Grebb, Synopsis of Psychiatry, Williams and Wilkins, 1994; National Institute of Mental Health
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