Factitious Disorders in Relationships: Symptoms, Causes & Treatment

Listen to this article

Imagine being in a relationship where your partner often claims to be unwell, yet medical tests show nothing wrong. 

This puzzling scenario could be a sign of a factitious disorder, a rare but impactful condition. People with this disorder pretend to be sick or deliberately make themselves ill for various reasons. 

Recognizing the signs of such behavior, understanding its underlying causes, and knowing how to effectively address it are crucial. Though not widespread, this condition sheds light on the complex interplay of emotional needs and relational dynamics.

What are Factitious Disorders in relationships?

Factitious disorders in relationships involve one person feigning, exaggerating, or actually inducing illness in themselves or others to gain attention, sympathy, or other emotional benefits. 

Unlike malingering, where the motivation is external gain like financial compensation, factitious disorders are driven by an internal need for the sick role. 

This behavior can strain relationships, as it often leads to unnecessary medical treatments and emotional distress. The person with the disorder might consistently lie about symptoms, manipulate medical tests, or even harm themselves to appear sick. 

What causes Factitious Disorders in relationships?

Factitious disorders in relationships, where a person simulates or induces illness, often stem from complex psychological and emotional factors. The causes aren’t always clear-cut, but several key elements are frequently observed:

• Past trauma or abuse can lead to factitious disorders as a way to cope or gain control.
• A deep-seated need for attention, care, and sympathy, often stemming from feelings of inadequacy or neglect.
• Personal or family history of serious illness can normalize the sick role as a means of getting attention.
• Underlying personality disorders may predispose individuals to this behavior.
• Dysfunctional relationship patterns can foster an environment where one resorts to illness fabrication to maintain connection or relevance.
• Coexisting mental health problems like depression or anxiety can exacerbate tendencies towards factitious behavior.

Understand in detail the cause of factitious disorder through this video:

9 symptoms of Factitious Disorders in relationships

Understanding these symptoms is crucial in identifying and addressing factitious disorders in relationships. It’s a complex condition that often requires a multi-faceted approach involving both psychological and medical interventions.

1. Exaggeration of symptoms

One of the primary symptoms of factitious disorder is the exaggerated portrayal of health issues. Individuals may describe their symptoms in overly dramatic terms, often with inconsistencies over time. This exaggeration goes beyond normal concern about health and enters the realm of fabrication for emotional gain.

2. Inconsistency in medical history

This inconsistency often becomes apparent over time as medical professionals struggle to reconcile their accounts with medical records and tests.

3. Frequent hospital visits

A common factitious disorder example is frequent and often unnecessary hospital visits. Individuals with this disorder have a pattern of seeking medical attention more often than is typical, even when there are no genuine symptoms necessitating such visits.

4. Eagerness for medical tests

Those with factitious personality disorder typically show an unusual eagerness to undergo medical tests, procedures, or even surgeries. Despite the risks or discomfort associated with these interventions, they often push for them as a way to validate their illness.

5. Reluctance to allow healthcare providers to communicate with family

Individuals with factitious personality disorder may be reluctant or outright refuse to allow healthcare providers to discuss their medical condition with family or friends. This control helps maintain their fabricated narrative, preventing others from uncovering the truth.

6. Symptoms that worsen with attention but improve in the absence

A unique aspect of factitious personality disorder is that symptoms often worsen when under medical care or receiving attention but improve when the individual is alone or unnoticed. This pattern suggests a psychological motivation behind the symptoms rather than a physiological cause.

7. Knowledgeable about medical terminology and conditions

People with factitious personality disorder often possess an unusually deep knowledge of medical terminology and conditions. This knowledge is often used to make their fabricated illnesses more believable to healthcare professionals and loved ones.

8. Presence of symptoms only when observed

A critical symptom of factitious disorder is the presence of symptoms only when others are observing. The individual may appear in distress or show signs of illness when they are being watched but seem fine when they believe no one is looking.

9. Changing symptoms in response to test results

Finally, those with factitious personality disorder tend to alter their symptoms in response to medical test results. If a test contradicts their claimed condition, they may change their symptoms or come up with a new ailment that aligns with the test findings or explains away the inconsistency.

How is a factitious disorder diagnosed?

Diagnosing a factitious disorder is a challenging and delicate process, primarily due to the nature of the disorder itself, where individuals deliberately fabricate or exaggerate symptoms. 

Generally, healthcare professionals begin by ruling out any genuine medical conditions. They review the patient’s medical history, looking for inconsistencies between reported symptoms and test results. 

Frequent hospital visits and a pattern of seeking extensive medical tests without clear necessity are red flags. A detailed psychiatric evaluation is often crucial, as it helps to understand the individual’s mental health, past traumas, and psychological needs. 

This evaluation is aimed at identifying underlying motivations for the behavior, such as a deep-seated need for attention or care. It’s important to note that diagnosing factitious disorder requires sensitivity; it involves understanding the psychological distress leading to the behavior rather than merely focusing on the deception aspect. 

This comprehensive approach helps in distinguishing factitious disorder from other mental health conditions, ensuring appropriate and empathetic care.

7 ways to treat factitious disorder 

Factitious disorder, a complex psychological condition, requires a multifaceted treatment approach. Combining psychotherapy, family involvement, and careful monitoring, treatment focuses on both psychological healing and managing co-occurring conditions.

1. Establish a supportive healthcare team

Effective factitious disorder treatment often begins with assembling a supportive healthcare team. This team, typically consisting of mental health professionals, primary care physicians, and sometimes specialists, works collaboratively to address both the physical and psychological aspects of the disorder. 

The team focuses on building a trusting relationship with the patient, which is crucial for successful treatment.

2. Psychotherapy

Psychotherapy is a cornerstone in treating factitious personality disorder. Cognitive-behavioral therapy (CBT) is particularly effective, as it helps patients understand the thoughts and feelings that drive their behavior. 

Therapists work with patients to develop healthier coping mechanisms and address underlying issues such as low self-esteem or past trauma, which are often at the root of the disorder.

3. Medication for co-occurring conditions

While there are no specific medications to cure factitious personality disorder, pharmacological treatment can be beneficial for co-occurring conditions such as depression, anxiety, or personality disorders. 

By managing these accompanying issues, the urge to fabricate or induce symptoms can be reduced.

4. Family therapy

Involving family members in the treatment process can be beneficial. 

This approach also addresses any dysfunctional family dynamics that may contribute to the disorder.

5. Monitoring and supervision

Monitoring and supervision are essential, especially in cases where self-harm is a concern. This aspect of factitious disorder treatment involves close collaboration with medical professionals to ensure that the patient is not seeking unnecessary medical procedures or manipulating test results. 

Regular check-ins and honest communication between the healthcare team and the patient are vital.

6. Long-term follow-up

Factitious personality disorder requires long-term management. Regular follow-up appointments with mental health professionals help monitor progress and prevent relapses. Continuity of care is crucial as it allows for adjustments in treatment strategies based on the patient’s evolving needs and responses.

7. Building a support network

Finally, building a robust support network outside of the healthcare setting is crucial for individuals with factitious personality disorder. Support groups, either in-person or online, can provide a sense of community and understanding. 

Encouraging the patient to engage in social activities and hobbies can also help them find fulfillment and self-worth in areas outside of the illness identity.

FAQs

Understand the key questions about factitious disorder, exploring its prevalence, prevention, complications, warning signs, impact on daily life, and the overall takeaway from understanding this complex condition.

• How common is factitious disorder?

Factitious disorder is considered rare, but the exact prevalence is difficult to determine due to its deceptive nature. It’s estimated that a small percentage of hospital patients may have this disorder, but many cases go undiagnosed or misdiagnosed. The hidden nature of the condition makes accurate statistics challenging to obtain.

• Can factitious disorder be prevented?

Prevention of factitious disorder is challenging since its causes are complex and not entirely understood. However, early intervention in cases of identified risk factors, such as childhood trauma or a history of mental health issues, may help. Educating healthcare professionals to recognize early signs can also aid in timely intervention.

• What are the complications of factitious disorder?

The complications of factitious disorder are both psychological and physical. Psychologically, it can lead to chronic mental health issues and strained relationships. 

Physically, self-induced illnesses or injuries can result in real, sometimes severe, health complications. It can also lead to unnecessary medical procedures and financial burdens.

• What are the red flags of factitious disorder?

Red flags include inconsistent medical histories, eagerness for medical tests or surgeries, symptoms that only appear in the presence of others, and symptoms that do not align with test results. Frequent hospital visits and a deep knowledge of medical terminology are also warning signs.

• How does factitious disorder affect daily life?

Factitious disorder can significantly impact daily life. It can lead to social isolation, strained relationships, and difficulty maintaining employment. The constant pursuit of medical attention can dominate an individual’s life, overshadowing other interests and activities. This can result in a significant decline in overall quality of life.

Takeaway

Understanding factitious disorder is crucial for effective management and treatment. Recognizing the signs and addressing both the psychological and physical aspects are key. With appropriate intervention and support, individuals with factitious disorder can work towards a more balanced and healthier life, both mentally and physically.

This condition, though challenging, can be managed with a compassionate and comprehensive approach, emphasizing the importance of both medical and psychological care in treatment.