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Factitious Disorders

What Are the Symptoms of Factitious Disorders?

Possible warning signs of factitious disorders include:

  • Dramatic but inconsistent medical history
  • Unclear symptoms that are not controllable and that become more severe or change once treatment has begun
  • Predictable relapses following improvement in the condition
  • Extensive knowledge of hospitals and/or medical terminology, as well as the textbook descriptions of illness
  • Presence of many surgical scars
  • Appearance of new or additional symptoms following negative test results
  • Presence of symptoms only when the patient is with others or being observed
  • Willingness or eagerness to have medical tests, operations, or other procedures
  • History of seeking treatment at many hospitals, clinics, and doctors offices, possibly even in different cities
  • Reluctance by the patient to allow health care professionals to meet with or talk to family members, friends, and prior doctors

What Causes Factitious Disorders?

The exact cause of factitious disorders is not known, but researchers are looking at the roles of biological and psychological factors in the development of these disorders. Some theories suggest that a history of abuse or neglect as a child, or a history of frequent illnesses that required hospitalization might be factors in the development of the disorder.

How Common Are Factitious Disorders?

There are no reliable statistics regarding the number of people in the U.S. who suffer from factitious disorders. Obtaining accurate statistics is difficult because dishonesty is common with this condition. In addition, people with factitious disorders tend to seek treatment at many different health care facilities, which can lead to statistics that are misleading.

In general, factitious disorders are more common in men than in women. However, factitious disorder by proxy tends to be more common in women than in men.

How Are Factitious Disorders Diagnosed?

Diagnosing factitious disorders is very difficult because of, again, the dishonesty that is involved. Doctors must rule out other possible physical and mental illnesses before a diagnosis of factitious disorder can be considered.

If the doctor finds no physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a factitious disorder. The doctor bases his or her diagnosis on the exclusion of actual physical or mental illness, and his or her observation of the person's attitude and behavior.

How Are Factitious Disorders Treated?

The first goal of treatment for a factitious disorder is to modify the person's behavior and reduce his or her misuse or overuse of medical resources. In the case of factitious disorder by proxy, the main goal is to ensure the safety and protection of any real or potential victims. Once the initial goal is met, treatment aims to work out any underlying psychological issues that may be causing the person's behavior.

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