Factitious disorder
| Factitious disorder | |
|---|---|
| Classification and external resources | |
| Specialty | psychiatry |
| ICD-10 | F68.10, F68.11, F68.12, F68.13 |
| ICD-9-CM | 300.16, 300.19, 301.51 |
| MeSH | D005162 |
A factitious disorder is a condition in which a person acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms. Factitious disorder imposed on another is a condition in which a person deliberately produces, feigns, or exaggerates the symptoms of someone in his or her care.
Münchausen syndrome, a severe form of factitious disorder, was the first kind identified, and was for a period the umbrella term for all such disorders.
People with this condition may produce symptoms by contaminating urine samples, taking hallucinogens, injecting themselves with fecal material to produce an abscess, and other similar behaviour.
They might be motivated to perpetrate factitious disorders either as a patient or by proxy as a caregiver to gain any variety of benefits including attention, nurturing, sympathy, and leniency that are seen as not obtainable any other way. In contrast, somatic symptom disorders, though also diagnoses of exclusion, are characterized by multiple somatic complaints that are not produced intentionally.
The DSM-5 differentiates among two types:
The motives of the patient can vary: for a patient with factitious disorder, the primary aim is to obtain sympathy, nurturance, and attention accompanying the sick role. This is in contrast to malingering, in which the patient wishes to obtain external gains such as disability payments or to avoid an unpleasant situation, such as military duty. Factitious disorder and malingering cannot be diagnosed in the same patient, and the diagnosis of factitious disorder depends on the absence of any other psychiatric disorder. While they are both listed in the DSM-IV-TR, factitious disorder is considered a mental disorder, while malingering is not.
Factitious disorder should be distinguished from somatic symptom disorder (formerly called somatization disorder), in which the patient is truly experiencing the symptoms and has no intention to deceive. In conversion disorder (previously called hysteria), a neurological deficit appears with no organic cause. The patient, again, is truly experiencing the symptoms and signs and has no intention to deceive. The differential also includes body dysmorphic disorder and pain disorder.
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