What is it?

Factitious disorder 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, injured or impaired.
Factitious disorder is not the same as inventing medical problems for practical benefit, such as getting out of work or winning a lawsuit. 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 caused by the self-harm typical of this disorder.

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Signs & symptoms

Factitious disorder symptoms involve mimicking or producing illness or injury or exaggerating symptoms or impairment to deceive others. People with the disorder go to great lengths to hide their deception, so it may be difficult to realize that their symptoms are actually part of a serious mental health disorder. They continue with the deception, even without receiving any visible benefit or reward or when faced with objective evidence that doesn't support their claims.

Factitious disorder signs and symptoms may include Clever and convincing medical or psychological problems such as:
* Extensive knowledge of medical terms and diseases
* Vague or inconsistent symptoms
* Conditions that get worse for no apparent reason
* Conditions that don't respond as expected to standard therapies
* Seeking treatment from many different doctors or hospitals, which may include using a fake name
* Reluctance to allow doctors to talk to family or friends or to other health care professionals
* Frequent stays in the hospital
* Eagerness to have frequent testing or risky operations
* Many surgical scars or evidence of numerous procedures
* Having few visitors when hospitalized
* Arguing with doctors and staff


Diagnosing factitious disorder is often extremely difficult. 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

To help determine if someone has factitious disorder, doctors:
* Conduct a detailed interview
* Require past medical records
* Work with family members for more information- if the patient gives permission
* Run only tests required to address possible physical problems
* May use the criteria for factitious disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association


Treatment of factitious disorder is often difficult, and there are no standard therapies. Because people with factitious disorder want to be in the sick role, they're often unwilling to seek or accept treatment for the disorder. However, if approached in a gentle, nonjudgmental way, a person with factitious disorder may agree to be treated by a mental health professional.

Nonjudgmental approach
Direct accusations of factitious disorder typically make the affected person angry and defensive, causing him or her to abruptly end a relationship with a doctor or hospital and seek treatment elsewhere. So the doctor may try to create an "out" that spares your loved one the humiliation of admitting to faking symptoms and offer information and help.
Either way, the doctor will try to steer your loved one toward care with a mental health professional. And both doctors and loved ones can reinforce healthy productive behaviors without giving undo attention to symptoms and impairments.

Treatment options
Treatment often focuses on managing the condition, rather than trying to cure it. Treatment generally includes:
* Having a primary care doctor.
* Psychotherapy.
* Medication- Medications may be used to treat additional mental health disorders, such as depression or anxiety.
* Hospitalization- In severe cases, a temporary stay in a psychiatric hospital may be necessary for safety and treatment.

Treatment may not be accepted or may not be helpful, especially for people with severe factitious disorder. In these cases, the goal may be to avoid further invasive or risky treatments. In cases where the factitious disorder is imposed on others, the doctor assesses for abuse and reports the abuse to the appropriate authorities, if indicated.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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