Previously known as Munchausen Syndrome and Munchausen by Proxy, Factitious Disorder is a mental disorder in which a person acts as if they have an illness, or impose an illness on someone else. They have consciously created their symptoms and may exaggerate or feign the symptoms in themselves or someone else. This may be done by purposely causing illness, self injury, or acting as if they are ill. They may tamper with diagnostic tests in order to have a positive result. It is a serious illness as it may cause severe harm or death to an individual or person in their care.
What are the symptoms?
The person with this disorder may not understand their behaviour or realise the results of their actions. It is not an attempt to miss work or school, but a real creation of illness or injury. Generally when imposed on another person (by proxy), it is a parent inflicting harm on a child, and is a form of child abuse.
Symptoms include:
Convincing medical problems with possible frequent hospitalisation.- Inconsistent symptoms that may become worse for no apparent reason
- Non responsive conditions to standard treatments
- A strong knowledge of medical terms and diseases and encouraging frequent tests or even operations for themselves or another person
- Ongoing requests for medications
- Seeking treatment and opinions from several doctors or hospitals
- Excluding family and friends from speaking with doctors about the diagnosis or condition
- Relapses frequently following an improvement in the condition
- Self -harm
What Causes Factitious Disorder?
There is not a known cause of Factitious Disorder. It is believed to be both biological and psychological factors that are present. Some research indicates that past abuse or neglect as a child may contribute, poor health or frequent need for hospitalisation, and possibly a link with personality disorders.
Those who inflict illness on others may do so for the reasons mentioned but also to assume the importance of a carer role. It may also be related to a grievance with the medical profession or a bad experience in hospital or with a previous treatment for the person or a family member. Often it is to draw attention and sympathy to themselves.
How is Factitious Disorder Diagnosed?
People with Factitious Disorder become very good at faking symptoms and illness, therefore making it difficult for doctors to determine if the illness is real or not. The person may be unable to control their behaviour when creating symptoms, injury or illness. They will seek help for the conditions they have created but rarely for the treatment of Factitious Disorder itself, and in fact may deny any association with this disorder.
The doctor must consider all symptoms and rule out any possible physical or other mental illnesses before diagnosing Factitious Disorder. If there is no apparent physical reason for the symptoms and the person continues to insist they exist, the doctor may refer them to a psychiatrist or psychologist based on the patient’s behaviour and attitude toward medical treatment. Some signs the doctor may observe include:
- Are recommended treatments working for the symptoms and do the symptoms make sense based on test results and assessments
- Is the person willing to undergo more testing and procedures or are they requesting them
- Is there other medical evidence such as previous records or family knowledge to confirm the patient’s history
When to seek help
If it is suspected that a person or loved one may be faking or exaggerating illnesses in themselves or someone else, it is important to take action as soon as possible. Try speaking to the person first about your concerns without accusing them of making it up. If they refuse to discuss it, become angry or engage in further self -harm or ongoing symptoms, contact a doctor to seek help and further advice. Try to monitor any medications they are taking or giving to someone else in order to control abuse or further harm from side effects or overdose.
Where to seek help
Factitious Disorder is very difficult to treat and usually there is a slow recovery, if any. If you suspect that a loved one may be showing symptoms of Factitious Disorder the following may assist in seeking help and treatment.
- Contact your doctor for referrals or information
- Contact the Community Mental Health Service in your local area
- The Australian Psychological Society may offer information or referrals 1800 333 497
- Mental Health Information Service 1300 794 991
- Mayo Clinic Website www.mayoclinic.org