Factitious disorder

Factitious disorder is a mental illness where patients fake or exaggerate symptoms of another illness to receive attentions or rewards. Such people often become sick fucks, and will very often blind themselves, infect themselves, or create conditions requiring amputation in order to seek attention from doctors.

This is distinct from malingering, where people fake disorders for direct rewards, such as food, tugboat money, controlled substances, housing, exemptions from military or civil duties, or to escape their families. Malingering is motivated by external goals, while factitious patients just seek attention.

In a nutshell, people with factitious disorder fulfill their emotional needs by seeking the attention gained from an illness. This is similar to how hardcore SJW's will fake being black in order to gain prestige from the SJW world. SJWs often are factitious when talking about any disease or illness because they are assholes who want attention for themselves. They do this at the expense of those who do have the disease, and at a great cost to other people.

The fakers

Methods of factitious disorder:

• Faking a medical history, such as cancer
• Adding gravel to urine samples
• Infecting a part of their body.
• Injects foreign material into a surgical wound to slow healing
• An epileptic patient has a seizure while EEG is normal
• Pouring acid on themselves to get on Oprah (http://www.cnn.com/2010/CRIME/09/20/washington.acid.hoax.charges/index.html)

Cases

• "a 23-year-old Canadian, faked terminal cancer. She shaved her head, starved herself, tattooed “won’t quit” on her fingers and solicited thousands of dollars in donations for a fake charity, before turning herself over to police this summer."
• "[a] woman in New York City recently faked leukemia to wheedle the community into paying for her dream wedding — complete with a honeymoon in Aruba — before she was revealed as a fraud and lost her husband, too."
• "a woman [in Colorado] who also pretended to have cancer and raised some $60,000 from friends and neighbors before being unmasked."

"Patient A, a 27-year-old female, would often present to the emergency department with vague complaints of abdominal pain and bright red blood per rectum, which she stated was typical for her Crohn’s disease. The patient also freely reported a psychiatric history with multiple diagnoses, including bipolar disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, a history of anorexia nervosa, and Asperger’s syndrome, as well as a history of suicide attempts and self-injurious behaviors. The patient had a stable income through state disability and lived in a comfortable home with her parents in an affluent neighborhood. Psychiatric consultation was requested on her third admission to the medical center and after 13 previous presentations to the emergency department. At that point she had undergone extensive diagnostic testing, including computed tomography scans, upper gastrointestinal (GI) endoscopy with small bowel follow through, colonoscopy, and biopsies, all of which had been unsuccessful in finding the cause of GI bleeding. She was transferred to the inpatient psychiatric hospital for complaints of depressed mood and her diagnosis was refined to PTSD and borderline personality disorder. During hospitalization, a nurse found the patient in the bathroom one night inserting a toothbrush into her rectum, producing the bloody stools that she had been complaining of for the past several days. When confronted, the patient articulated that she desired the attention that came with her medical work-ups and that it instilled a sense of control over her environment. This behavior was different from previous suicide attempts in that there was no intent to die. It was also distinct from her self-injurious behaviors which were performed openly and freely admitted to. As for the discrepancy between reported psychiatric diagnoses and those at time of discharge, this was due to diagnostic errors on the part of previous treatment teams, not due to misrepresentation by the patient. The patient thus met criteria for factitious disorder with predominantly physical symptoms."

"Patient B, a 52-year-old female with bipolar depression, was admitted to the inpatient unit for the fifth time in 6 months after presenting with suicidality and depressed mood. The patient stated that she had been diagnosed with OCD, PTSD, and attention-deficit/hyperactivity disorder. She also stated that she was blind and had a guide dog. During hospitalization, she consistently reported that her depression and suicidality were worsening. However, observations showed that the patient joked, laughed, and regaled others with far-fetched stories. She ate and slept well, and ambulated without difficulty. It also became increasingly obvious that Patient B was not blind. She was observed reading, looking in the mirror, and dialing numbers from her phone book. In daily sessions, inconsistencies were noted in her elaborate recollections of traumas. The management plan consisted of performing a diagnostic work-up including medical, neurologic, and neuropsychological evaluations, in addition to a trial of citalopram 40 mg PO and lamotrigine 200 mg PO, both at bedtime, as well as psychotherapy. Ophthalmology and neurology consults did not reveal any visual loss. The psychological and neuropsychological testing confirmed suspicions about the presence of significant antisocial, narcissistic, and borderline personality traits, and showed intact neuro-cognitive functioning. Additional information confirmed the patient’s tendency to move from hospital to hospital, leave against medical advice, and express inconsistent medical and psychiatric complaints, which gave evidence to the diagnosis of a factitious disorder. The most important two differential diagnoses were conversion disorder and malingering. Conversion disorder was ruled out because the patient was shown to have intact vision on medical consultations. Regarding malingering, there were no specific secondary gains as she had a stable housing and financial situation. It became clear that Patient B was intentionally producing both physical (blindness) and psychological (worsening of depression) symptoms in order to assume the sick role. She was informed of the diagnostic possibility of factitious disorder with combined psychological and physical signs and symptoms, and was recommended for continuation of both psychotherapy and pharmacotherapy."

"Patient C, a 38-year-old male, presented complaining of a 3–4-month history of depressed mood, poor energy, difficulty sleeping, poor appetite, psychomotor retardation, increasing hopelessness, and suicidal ideation with a plan to walk into traffic. Once on the inpatient wards, the patient remained compliant with his medications; however, no change in mood was seen. Throughout his stay, Patient C demonstrated, on a consistent basis, a discrepancy between what he stated to staff and what was observed on the wards. The patient consistently reported depressed mood and suicidality, but was observed to be euthymic, in good spirits, and carousing with the other patients. The patient’s stay was also significant for two suicide attempts both with low lethality and high possibility of rescue. Elaborate stories regarding the death of his best friend, as well as his previous married life, employment status, and relations with his family, were for the most part later repudiated by the patient’s father. Eventually, the patient was so disruptive to the inpatient milieu that he was placed in seclusion. Within a few hours he arranged to be picked up by a friend and was successful in finding a place to stay. Before being discharged, the patient admitted to never being suicidal and that the two suicide attempts had both been feigned. The treatment team noticed that the patient had traits of antisocial, narcissistic, borderline, and histrionic personality disorders. The likelihood of malingering was low because the patient had stable income and was offered numerous housing options, which he refused. The treatment team concluded that this patient was willing to assume the sick role, by intentionally manifesting psychological symptoms, to gain the social interaction of being in a psychiatric unit."

Treatments

The most important treatment method when dealing with factitious disorder is to make the patient feel like an asshole. Because they are a asshole.

• Stage an intervention with a group of doctors and psychiatrists, and let the patient know that they have been caught.
• Move the patient to a mental health ward.
• Put the patient on antipsychotic drugs. Especially Haldol.
• Use electroshock therapy.
• Use a lobotomy

http://www.currentpsychiatry.com/the-publication/past-issue-single-view/factitious-disorder-what-to-do-when-someone-plays-sick/6a5e0ee9296e63f0537a9d250a154f27.html

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Factitious disorder is part of a series on Psychology