159 Factitious Disorders (300.19)
DSM-IV-TR criteria
A. The patient is intentionally producing or pretending to have physical or psychological symptoms or signs of illness.
B. The patient’s motivation is to assume the role of a sick person.
C. There are no external motives that explain the behavior.
Associated Features
- Includes intentionally fabricating physical or psychological symptoms without having any actual illnesses. Motivation must lie in assuming the sick role and not for personal gain as in malingering.
- It can have predominantly psychological signs and symptoms, or predominantly physical signs and symptoms or a combination of psychological and physical signs and symptoms.
- Patients may do things to make it look like they are ill and need medical attention such as; contaminating urine sample, ingesting harmful substances like bacteria to invoke some sort of physical proof that they need care, taking hallucinogens, purposefully infecting minor cuts or scrapes to increase the severity and increase the medical attention administered. Can be seen in patient who seeks attention, sympathy, or leniency in some situations.
- Patients may have long medical histories with many hospital admissions. Their records are usually vague and inconsistent.
- The patient may have an unusual knowledge of the supposed disease as if they just had definitions to go off of without any true experience.
- They could be employed in a medical setting.
- Their hospital visits are usually around hospitals and weekends when the experienced staff is not working so they will have a less likely chance of being caught but still get the same treatment.
- The person will probably receive few hospital visits even if they claim to be an important figure.
- The patient may be unusually comfortable with invasive procedures, uncomfortable surgeries, or a drastic diagnosis.
- Their hospital behavior could be classified as controlling, hostile, attention-seeking, or disruptive.
- They may only present symptoms when they think they are being watched or when thought to be under surveillance and may disprove of surveillance.
- They are abusing medications, most commonly pain-killers.
- The illness that is being played out fluctuates, often with rapid progression.
- Self-inflicted wounds are most abundant.
Munshausen
- Munchausen Disorder is another term for Factitious Disorder.
- This is also known as Hospital Addiction Syndrome or Hospital Hopper Syndrome.
- This has the same diagnostic criteria as Factitious Disorder, seeking attention for being sick. Most often seeking sympathy and care. Sometimes multiple surgeries are performed before diagnosing this disorder.
Munchausen Syndrome by proxy
- Referred to in the DSM-IV-TR as Factitious Disorder by proxy, is a disorder in which someone delivers harm to someone else, most often a child, in order to gain attention. Its been described as an extended form of child abuse; it’s only difference is that it’s done for some sort of gain.
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