Factitious Disorder

Factitious Disorder (From the DSM-IV-TR)

Introduction

The essential feature of Factitious Disorder is the intentional production of physical or psychological signs or symptoms (Criterion A). The presentation may include fabrication of subjective complaints (e.g., complaints of acute abdominal pain in the absence of any such pain), falsification of objective signs (e.g., manipulating a thermometer to create the illusion of fever), self-inflicted conditions (e.g., the production of abscesses by injection of saliva into the skin), exaggeration or exacerbation of preexisting general medical conditions (e.g., feigning of a grand mal seizure by an individual with a previous history of seizure disorder), or any combination or variation of these. The motivation for the behavior is to assume the sick role (Criterion B). External incentives for the behavior (e.g., economic gain, avoiding legal responsibility, or improving physical well-being, as in Malingering) are absent (Criterion C).

Individuals with Factitious Disorder usually present their history with dramatic flair, but are extremely vague and inconsistent when questioned in greater detail. They may engage in pathological lying, in a manner that is intriguing to the listener, about any aspect of their history or symptoms (i.e., pseudologia fantastica). They often have extensive knowledge of medical terminology and hospital routines. Complaints of pain and requests for analgesics are very common. After an extensive workup of their initial chief complaints has proved negative, they often complain of other physical or psychological problems and produce more factitious symptoms. Individuals with this disorder may eagerly undergo multiple invasive procedures and operations. While in the hospital, they usually have few visitors. Eventually, a point may be reached at which the factitious nature of the individual's symptoms is revealed (e.g., the person is recognized by someone who encountered the patient during a previous admission; other hospitals confirm multiple prior hospitalizations for factitious symptomatology). When confronted with evidence that their symptoms are factitious, individuals with this disorder usually deny the allegations or rapidly discharge themselves against medical advice. Sometimes, they will be admitted to another hospital soon after. Their repeated hospitalizations may take them to numerous cities, states, and countries.

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I find this disorder really fascinating, mostly because I don't know how you would actually determine that someone's pain is not real. I find it very difficult to even explain my pain. When I went to the doctor for my foot, they asked me to rank my pain on a scale of 1-10, but that obviously had a physical sign of pain. They ask this same question when you go to psychologist, you rate your psychological pain on a scale. But how do you tell someone that they aren't really feeling a 9, but instead a 2?

You are disordered because you do not have a disorder, in a very simplistic way of explaining it. Catch-22, eh?

I also find it slightly humorous. What's worse than having a disorder? Having a factitious disorder. Also, good thing we have the Diagnostic and Statistical Manual, otherwise everyone would have this disorder. In fact, I'm going to say it. You all have factitious disorder. See, humorous.

I dunno, what do you people think about this? Lemme know, please.