Factitious Disorders
Kelly Gauthier
William Carey University
Factitious Disorders
The longing for attention, sympathy, nurturance and love can cause people to behave in destructive ways. These unfulfilled needs encourages some people to assume the sick role. When we are sick it seems that people come out of the woodwork to be supportive and helpful; we are praised as we fight to battle our illness, someone may bring us homemade chicken soup, doctors and nurses tend to us by giving us medical attention, we get sympathy cards and someone may sit with us so we always have company. The love our family and friends have for us is very apparent and the care given to us by our doctors and nurses are at their at their highest point. In some ways, it is nice to be sick, but most of us would rather be well since being sick is not a good feeling.
Signs and Symptoms
Persons with Factitious Disorder will feign or produce illnesses in order to assume the sick role (American Psychiatric Association, 2000). Something that is factitious is not natural, it is something that is manufactured or contrived. The diagnostic criteria listed in the DSM-IV-TR (American Psychiatric Association, 2000) for Factitious Disorder are:
A. Intentional production or feigning of physical or psychological signs or symptoms.
B. The motivation for the behavior is to assume the sick role.
C. External incentives for the behavior (such as economic gain, avoiding legal responsibility, or improving physical well-being, as in Malingering) are absent. (p.517)
There are three subtypes which Factitious Disorder is coded by. Subtype 300.16 is predominantly psychological signs and symptoms, in these cases patients will feign a wide variety of mental problems or can feign one mental disorder, which usually has atypical symptomology since the patient’s feigned disorder must morph when he or she feels as though the doctor is beginning to uncover the fact
References: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, (4th ed., text revision). Washington, DC: American Psychiatric Association. Asher, R. (1951). Munchausen’s syndrome. The Lancet, 257(6650), 339-341. doi:10.1016/S0140-6736(51)92313-6 Feldman, M.D., Ford, C.V., & Reinhold, T Gregory, J. (2003). Sickened: The memoir of a Munchausen by proxy childhood. New York, NY: Bantam Dell. Lasher, L.J. & Sheridan, M.S. (2004). Munchausen by proxy: Identification, intervention, and case management. Binghamton, NY: The Haworth Press, Inc. Libow, J.A. (2000). Child and adolescent illness falsification. Pediatrics, 105(2), 336-342. Mart, E.G. (2004). Factitious Disorder by proxy: A call for the abandonment of an outmoded diagnosis. The Journal of Psychiatry & Law, 32, 297-313. O’Shea, B. (2003). Factitious Disorders: the Baron’s legacy. International Journal of Psychiatry in Clinical Practice, 7, 33-39. Precey, G. (1998). Assessment issues in working with mothers who induce illness in the children. Child and Family Social Work, 3, 227-237. Schreier, H. (2002). Munchausen by proxy defined. Pediatrics, 110(5), 985-988. Seligman, L. & Reichenburg, L. (2012). Selecting effective treatment: A comprehensive systematic guide to treating mental disorders. Hoboken, NJ: John Wiley & Sons, Inc.