Pretending to receive attention: fictitious disorder

Suspicions that a loved one, a family member or friend often does not be sick? It could suffer from a Fictitious disorder.

What is fictitious disorder?

Fitty disorder is a mental condition for which those who are affected intentionally produces the symptoms of a physical or mental illness.

In particular, according to the diagnostic and statistical manual of mental disorders, 5th edition, the Fitty disorder is diagnosed When one or more of the following conditions occur:

1. Intentional provocation or amplification of physical or psychological signs of illness.
2. The person shows himself to others as a sick, impaired or wound.
3. The deceptive behavior is clear, even in the absence of obvious external advantages.

Therefore the possible signs that can represent a alarm bell for the presence of a fictitious disorder I am:

1. The person says he had a series of diseases in the past, but does not have any documentation in this regard (reports, analysis, copies of folders, etc.).
2. When a documentation is present, however, it is noted that the symptoms reported are inconsistent with laboratory results or instrumental exams.
3. New symptoms are always reported whenever the precedents do not lead to any precise diagnostic definition.
4. The person often has “repercussions” every time he begins to heal.
5. Any treatment tends to worsen symptoms instead of improving them.
6. The person complains of having some symptoms that however cannot show because they only take place when “he is alone”.

The self -injurious dimension

In some cases, real self -injurious behaviors are implemented, for example:

• Ingestion of cleaning products or other toxic chemicals;
• intake of drugs to cause diarrhea and vomiting;
• intentionally come into contact with agents who trigger an allergic reaction;
• Do not allow a wound (also surgical) to heal.

People with this condition I am unable to refrain from these behaviorseven when they want it and this also determines complex relationships with the health figures with which they come into contact, so as to occur situations of this type:

• They often have a good knowledge of medical practice and repeatedly ask to undergo diagnostic tests and/or surgical procedures;
• They do not wish that the doctors speak with their family members or with the other doctors who have had them in care in the past;
• They are not willing to a psychiatric evaluation;
• Sometimes they come to the hospital asking for hospitalization for a non -existent disease but told with dramatic tones;
• Once hospitalized, just recognized by the health workers, the fictitious nature of the symptoms reported, quickly ask for discharge, to recur perhaps in another hospital with the same type of request.

However, this pathological behavior must be distinguished from the actual simulation, since the two manifestations seem very similar.

What is the difference between fictitious disorder and simulation?

The fundamental difference between these two conditions lies in the motive, that is, in the reasons that push a person to pretend to be sick. In both conditions, a pathology is simulated in a completely conscious way, but the purposes for which you do are different:

• People with fictitious disorder create symptoms without apparent tangible and recognizable benefit. Their reason seems to be more linked to “internal” incentives, such as the desire to get care and attention on the part of others, whether they are family members, acquaintances or health personnel;
• The simulation of a disease, on the other hand, aims to obtain clearly visible “external” advantages, such as avoiding work or obtaining financial compensation; Once these objectives are achieved, the symptoms disappear.

Causes of fictitious disorder

The causes of fictitious disorder are unknown, but it is thought that child traumatic experiences play a very important role. Scholars tend to agree on the fact that people with these disorders have had a childhood characterized by episodes of abandonment and neglect by parents or serious diseases borne by themselves or a family member. Or, in general, they have experienced experiences that led them to believe that care and attention are provided only with those in disadvantaged conditions or are in a state of illness.

The fact of simulating a disease can be a way of increasing or protecting one’s self -esteem, making the fault of social or working problems fall on the disease itself.

Personality disorders can also be connected to fictitious disorder. In particular, these may include:

• Antisocial personality disorder
• Borderline personality disorder
• Narcissistic personality disorder

Other epidemiological elements that have been found:

• Age. A 2006 study suggests that this condition can be more common in people aged 20 and 40.
• Type. No relevant differences in prevalence have been found between the two sexes.
• State of the relationship. People with this condition tend not to be married or to have interrupted family relationships.

Treatment of fictitious disorder

The fundamental objective to be pursued in the treatment of fictitious disorders naturally consists in putting an end to the person’s self -elegant behavior.

A psychotherapeutic path is indicated, although very often these people are not motivated to collaborate with the therapeutic process. In fact, they are very related to their need to assume the role of patient and deny the existence of the disorder.

The therapeutic path must go to change the belief that empathy can be obtained with others only through a relationship aimed at taking care of one’s own disease.

These people must acquire the ability to come into emotional contact with others as people and not as sick. They must understand how, when and why they have developed their beliefs and ways of behaving distorted and developing new relational skills.

Psychotherapy also aims to:

• obtain support for previous trauma or abuses;
• Learn new strategies to face stress;
• face any underlying mental disorders, such as anxiety, depression or personality disorder.

Bibliography

• American Psychiatric Association (APA). The Diagnostic and Statistical Manual of Mental Dysorders, 5th Edition, Text Revision, 2022. Washington, DC.
• Pankratz L, Lezak MD. Cerebral Dysfunction in The Munchusen Syndrome. J clinchiatry. 1987; 9 (2): 195-206)
• Krahn Le, Li H, O’Connor Mk. Patienti Who Strive to Be ill: facititious disorder with physical sympoms. AM J Psychiatry. 2003 jun; 160 (6): 1163-8
• Kamil Jaghab, MD, Kenneth B. Skodnek, MD, and Tanveer A. Padder, Munchusen’s syndrome and other facitious disorders in Children Psychiatry (Edgmont). 2006 Mar; 3 (3): 46–55.
• Kevin T. Carnahan, Aupam Jha. Facititious Disorder in: Statpearls (Internet). Treasure Island (FL): 2023 Jan.