Factitious disorders are conditions in which a person deliberately and consciously acts as if he or she has a physical or mental illness when he or she is not really sick. Factitious disorder by proxy is when a person acts as if a person in their care has an illness when they do not.
People with factitious disorders deliberately create or exaggerate symptoms of an illness in several ways. They may lie about or fake symptoms, hurt themselves to bring on symptoms, or alter tests (such as contaminating a urine sample) to make it look like they or the person in their care are sick.
Two doctor/brothers, Joel and Ian Gold, have identified symptoms of a mental
illness unique to our times: the Truman Show delusion, named for the 1998 movie
that starred Jim Carrey as a suburbanite whose movements were filmed 24/7 and
broadcast to the world. The two say a handful of individuals are convinced they
are stars of an imaginary reality show.
Though limited, their findings are creating a buzz in the media and the
psychiatric community: Is it possible that reality TV is shaping delusions?
People with factitious disorders behave this way because of an inner need to be seen as ill or injured, not to achieve a clear benefit, such as financial gain. People with factitious disorders are even willing and sometimes eager to undergo painful or risky tests and operations in order to obtain the sympathy and special attention given to people who are truly ill or have a loved one who is ill. Factitious disorders are considered mental illnesses because they are associated with severe emotional difficulties.
Many people with factitious disorders also suffer from other mental conditions, particularly personality disorders. People with personality disorders have long-standing patterns of thinking and acting that differ from what society considers usual or normal. These people generally also have poor coping skills and problems forming healthy relationships.
Factitious disorders are similar to another group of mental disorders called somatoform disorders, which also involve the presence of symptoms that are not due to actual physical or mental illnesses. The main difference between the two groups of disorders is that people with somatoform disorders do not fake symptoms or mislead others about their symptoms on purpose.