Factitious Disorder Diagnosis
(Also Known As: Factishus Disorder Diagnosis, Munchausen Syndrome Diagnosis, Somatoform Disorder Diagnosis, Factitious Diagnosis, Malingering Diagnosis)
(Reviewed by: Paul Peterson, Licensed Therapist)
How is Factitious Disorder Diagnosed?
Factitious disorder involves a deceitful act that makes the diagnosis more difficult. It is vital to diagnose true or real medical condition and mental illness in factitious disorder. Diagnostic procedures such as laboratory tests can help exclude the other possible causes of factitious disorder and clinicians should be able to establish a differential diagnosis of the condition from malingering, somatoform disorder, body dysmorphic disorder, pain disorder, conversion disorder, as well as other psychological disorders that may accompany the factitious disorder.
The DSM-IV has specific criteria that must be met in order to establish a factitious disorder diagnosis: 6
There is an intentional feigning of the psychological and physical symptoms of an illness.
The motivation behind the behavior is to assume a sick role
There is an absent of external incentive of the behavior such as financial and economic gain and avoiding legal responsibilities which are characteristics of malingering.
One diagnostic procedure used to determine and assess the presence of factitious disorder is through laboratory tests. Usually the diagnosis for factitious disorder is concluded only after all diagnostic possibilities have been explored and exhausted. Laboratory tests are helpful in facilitating the diagnosis for the presented illnesses as factitious. Accurate objective findings are obtained such as when the patient claims to have kidney stones they can be asked to undergo the urine filter for stones which can be submitted for test. Tissue biopsies are also helpful tools to help reveal the factitious nature of the lesion by identifying materials that has been injected in order to simulate a particular disease. 7
PROPOSED PRACTICAL DIAGNOSTIC CRITERIA 8
Severe disorder that is usually incompatible to the individual’s employment, family ties, and interpersonal relationships with onset in early adulthood and follows a chronic course.
The characteristics of symptomatology include:
Symptoms are inconstant with marked changes from one day to another or from one hospitalization to the next one.
Changes in the symptoms are unrelated to treatment but are due to environmental influences manifested by mimicry and exacerbation of what the patient feels when observed.
Association of other factitious disorders
There is an association of symptoms that are uncommon that occur simultaneously and/or successively that may belong to other mental illnesses.
There is difficulty in obtaining the patient’s medical history and biographical data due to the following reasons:
the data provided by the patient is vague, exaggerated and dramatic while putting forward memory dysfunctions
The patient has no or few visitors that prevent the staff from contacting family members or close friends of the patient to provide them information.
The external material incentives are either absent or the symptoms are exaggerated considering the advantages.
Could You Have Factitious Disorder?
Factitious Disorder Topics
|Adjustment Disorder – psychological response to identified stressors, anxiousness, depression, stress disorder|
|Borderline Personality Disorder – distorted behavior, self image and personality, mood disorder, dissociation|
|Dissociative Identity Disorder – multiple distinct personalities/identities, alter egos, memory loss, depression, de-realization, amnesia, phobias, anxiety|
|Dysthymic Disorder – chronic mood disorder, anxiety, depression, drug addiction, alcoholism|
|Malingering – fabricated symptoms for possible external gains, exaggerated symptoms, feigning symptoms of an illness|
|Munchausen Syndrome – feigning of symptoms and illnesses, malingering to draw sympathy from others |
|Narcissistic Personality Disorder – self centered, attention seeking, ego, self loved, conceit|