Munchausen syndrome is a mental health condition in which the person feigns or forces illness by injuring themselves, contaminating urine samples, or purposefully contracting a disease. A number of motivations can prompt these actions. Physicians now call Munchausen syndrome factitious disorder. Factitious disorder imposed on self refers to a person exaggerating or creating symptoms purely involving themselves. Factitious disorder imposed on another means the individual with the disorder falsified or purposefully caused illness in another adult, a child, or a pet.

Factitious Disorder Imposed on Self

Typically, a person with factitious disorder imposed on self will create or dramatically exaggerate symptoms of an illness. They may do so to receive examination or treatment from a hospital or because they want attention, sympathy, or comfort from peers, family, or doctors. In some instances of this disorder, the individual may become highly knowledgeable about medical practices and illnesses in order to more convincingly mimicking symptoms that require intensive medical evaluation.

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Factitious Disorder Imposed on Another

Factitious disorder imposed on another or FDIA was once called Munchausen syndrome by proxy. This disorder compels a parent or guardian to feign disease or illness in a dependant, such as a child, older adult, or pet. For children, this usually results in frequent hospital visits and treatments. In extreme cases, a person may even harm the dependant, employing poisons, disease, or physical abuse. Many debates consider whether or not FDIA is child or elder abuse.

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Because factitious disorder is a mental health issue, it can be difficult for people other than the affected person to understand what is happening. The reasons behind his or her actions are open to interpretation, and outside individuals may debate the driving force of these actions. Many people with factitious disorder innately desire sympathy and attention. This may be the primary motivator of their actions. For some, playing the role of a patient is comforting and familiar. Some experts believe people with FDIA desire to act as a hero or caregiver to an unwell dependent, a goal achieved by harming, infecting, or falsifying symptoms in another person.

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Mimicking Symptoms

People with either form of factitious disorder use a variety of methods to mimic diseases and symptoms. In some cases, this involves ingesting substances, such as consuming excessive levels of salt to create a sodium imbalance. Others may manipulate blood, urine, or stool tests; introducing blood to urine or stool samples can mimic a bladder or intestinal condition. In extreme cases, the factitious disorder may even compel a person to harm themselves physically. As an example, to mimic haematuria or bloody urine, a person may deliberately injure their urethra.

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Factitious Disorder vs. Hypochondria

There are some similarities between factitious disorder and somatoform disorders like hypochondria. People with either condition may appear to others as if they are falsifying an illness or exaggerating symptoms. However, there are key differences between the conditions. Generally, people with factitious disorder are deliberately attempting to mimic the disease or a disorder. Those with hypochondria believe that any physical or psychological symptom is a guarantee that they have a serious illness (though they do not necessarily want it). Even after an examination refutes their beliefs, a hypochondriac will likely still believe they are sick.

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Factitious Disorder vs. Malingering

Both factitious disorder and malingering involve fabricating symptoms of mental or physical disorders. However, a person with factitious disorder is not seeking material gain. A malingerer is seeking a tangible benefit by pretending to have an illness. They may wish to avoid work, school, or other responsibilities, or hope to obtain prescription medications. Malingerers pose a certain level of risk to economic systems. They may be attempting to receive workers compensation, disability benefits, or to gain money in a lawsuit.

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Diagnosing Factitious Disorder Imposed on Self

Diagnosing a factitious disorder can be incredibly difficult. If a patient manipulates a blood, urine, or stool sample, the patient likely will not have physical reasons for the test results. As a result, a medical expert may suspect factitious disorder and refer their patient to a psychiatrist or psychologist. These psychiatrists and psychologists will use a thorough combination of physical examinations, medical histories, and psychological tests. If a person with factitious disorder has significant medical knowledge, their condition may be impossible to diagnose.

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Signs of Factitious Disorder Imposed on Self

Several key signs may hint at the presence of factitious disorder imposed on self, and these can help a doctor reach a diagnosis. People with unique and inconsistent medical histories may have feigned some of their illnesses. While most people dislike seeing the doctor and getting tests, individuals with this disorder are often willing or eager to have medical procedures and examinations; they may even suggest them. One of the major signs of factitious disorder is a desire for more testing or the emergence of new symptoms following negative test results.

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Warning Signs of FDIA

Diagnosing FDIA can be even more difficult, though certain warning signs may alert a medical practitioner to the possibility of the condition. Some examples of these warning signs are:

  • A parent or guardian exhibits significant medical knowledge while seeming to enjoy the hospital environment. They frequently express interest in intricate details of other patients’ illnesses;
  • a child has frequent medical problems that do not respond to treatment;
  • symptoms or lab results are clinically or physically impossible;
  • a family history with similarly unexplainable illnesses in siblings.

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Treating factitious disorder or Munchausen disease is a complex and intricate process and varies heavily from patient to patient. It is possible for a mood disorder to be at the root of the issue, and medications such as selective serotonin reuptake inhibitors (SSRIs) may treat this underlying cause. Some people with factitious disorder respond well to family therapy. Rather than treating the individual, mental health professionals inform the family of the person’s needs and desires. Many of the actions of factitious disorder stem from a desire for attention. It is possible that by providing that attention, a family may halt or prevent these actions.

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