GROUP-1

FACTITIOUS DISORDER
[300.19(F68.10)]
BY M. SAI VANDANA- 22 AND S.R. MADHURI SHARWANI- 32
WHAT IS FACTITIOUS DISORDER?

Factitious disorder is a DSM-5 (Diagnostic and Statistical Manual of

Mental Disorders) diagnosis assigned to individuals who falsify illness in
themselves or in another person, without any obvious gain. Malingering (where
an individual falsifies symptoms for personal gain) is anther term used in this disorder.
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 symptoms can range from mild to severe ( called
Munchausen syndrome).
SYMPTOMS OF FACTITIOUS DISORDER

Factitious disorder symptoms involve mimicking or producing illness 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 a part of a serious mental health disorder.
Some behaviors, however, do make factitious disorder easier to spot, including:
• Inconsistencies between patient history and medical observations.
• Vague details that seem plausible on the surface but that don’t hold up to scrutiny.
• Lengthy medical records with multiple admissions at different hospitals.
• Willingness to accept any discomfort and risk from many medical procedures, even surgery.
• Overdramatic or outlandish presentation of a factitious illness, or hostility when challenged.
CAUSES OF FACTITIOUS DISORDER

• Factitious disorder is still not very well understood - a low number of individuals
from a wide range of backgrounds are successfully diagnosed with the condition.
As such, it is difficult to identify causes of factitious disorder with any certainty.
• Risk factors are believed to include childhood trauma, working in the healthcare
profession and suffering from depression or a personality disorder.
• It is suggested that the dynamics of a parent and child relationship may also be
a contributing element if these relationships result in:
• - a need to be loved or cared for ; a need for control ;  a need to master abusive
parents
- a need to deceive ; a need to be hurt or punished.
LIVING WITH FACTITIOUS DISORDER

 Factitious disorder affects both the individual and those around them to a
significant degree. Friends, family and other acquaintances generally
experience the effects of factitious disorder more acutely than the sufferer
themselves, often as a result of the individual being unwilling to confess to
their deception.
 The individual will have a need to receive attention and care, and will often
go through many unnecessary and potentially risky methods like surgery in
order to obtain what they desire.
Life for those around such individuals can be stressful. An individual with
factitious disorder may find doctors distance themselves, or cease all
treatment except that required to prevent death.
DIAGNOSTIC CRITERIA FOR FACTITIOUS
DISORDER
There are four primary criteria for diagnosing factitious disorder. These
are:
• Intentional induction or falsification of physical or psychological signs or symptoms.
• The individual presents themselves as ill, impaired or injured to others.
• The deceptive behavior persists even in the absence of external incentives or rewards.
• Another mental disorder does not better explain the behavior.

• Factitious disorder may be diagnosed as either a single episode or as

recurrent episodes (two or more instances of illness falsification and/or
induction of injury).
DIAGNOSTIC CRITERIA FOR FACTITIOUS
DISORDER ON ANOTHER
Factitious disorder imposed on another (formerly known as
previously called Munchausen syndrome by proxy) may be broadly
diagnosed using the same four criteria as above:
• Intentional induction or falsification of physical or psychological signs or
symptoms in another person.
• The individual presents another individual (the victim) as ill, impaired or injured
to others.
• The deceptive behavior persists even in the absence of external incentives or
rewards.
• Another mental disorder does not better explain the behavior.
MUNCHAUSEN
SYNDROME
As with factitious disorder,
in another may be
diagnosed as either a
single episode or as
recurrent episodes . With
factitious disorder in
another, the victim may
be assigned an abuse
diagnosis as a result of the
perpetrator’s behavior or
TREATMENT FOR FACTITIOUS DISORDER

 There is no known single treatment for factitious disorder. A key

difficulty in creating treatments for the disorder is simply how few cases are
reported, and how even fewer of those go on to receive continued long-term
treatment options.  However, that few individuals with factitious disorder
choose to receive psychiatric treatment.

 Cognitive behavioral therapy may be used as a treatment method and

Family therapy may also be suggested to help those around the individual
understand and manage the disorder, which in turn will aid the individual .
Medication may be used to treat symptoms and/or any co-occurring
psychiatric disorders but not usually to treat factitious disorder itself.
TREATING THE PATIENTS….
COMORBIDITY
As a result of its defining characteristics and the deception
of those who suffer from the condition, factitious disorder is
difficult to study. As such, most reports are single cases or
small case studies. (Steel, R. M. 2009)
However, there appear to be meaningful clinical links
discovered between factitious disorder and other mental
illnesses, such as borderline personality disorder.  (Gordon,
D. K., & Sansone, R. A. 2013)
PREVALENCE
The prevalence of factitious disorder is unknown, likely
because of the role of deception in this population. Among
patients in hospital settings, it is estimated that about 1%
of individuals have presentations that meet the criteria for
factitious disorder.
 DIFFERENTIAL DIAGNOSIS
• Caregivers who lie about abuse injuries in dependents solely to protect themselves from
liability are not diagnosed with factitious disorder imposed on another because protection
from liability is an external reward.

• Somatic symptom disorder - In somatic symptom disorder, there may be excessive

attention and treatment seeking for perceived medical concerns.
• Malingering - Malingering is differentiated from factitious disorder by the intentional
reporting of symptoms for personal gain (e.g., money, time off work).

• Conversion disorder (functional neurological symptom disorder) - Factitious

disorder with neurological symptoms is distinguished from conversion disorder by evidence
of deceptive falsification of symptoms.
• Borderline personality disorder - Factitious disorder requires that the induction of
injury occur in association with deception.

• Medical condition or mental disorder not associated with intentional

symptom falsification - For example, individuals who might manipulate blood sugar
levels to produce symptoms may also have diabetes.