Talk:Factitious disorder

Miscellaneous comments

I had to edit the bit on malingering as no sources or evidence were offered. The article talked about what a physician may perceive, but this is subject and again no evidence was offered.

Dictionary.com talks about feigning illness - which I think is a better descriptor malingerer, rather than becoming academic as to "why" a person may malinger.

I have edited the article to make it more neutral. Acontributor 11:41, 8 May 2006 (UTC)

Dictionary entries are not evidence. -- Antaeus Feldspar 13:58, 9 May 2006 (UTC)

Ganser's

Isn't Ganser Syndrome no longer considered factitious? Can someone clarify this? I'm pretty sure it's mentioned in the Wikipedia section on Ganser's, so one or the other needs to be corrected. —Preceding unsigned comment added by 63.3.7.1 (talk) 05:18, 26 June 2008 (UTC)

Alternative explanations for presentation of factitious disorders and malingering needed

I do not have the expertise to write high-enough quality material for this to add to the articles, but I feel it is VERY important to make mention of the fact that many people present with conditions or combinations of conditions which are very hard to diagnose, and the time and resources of the medical establishment are limited in such a way that misdiagnoses and subsequent lack of treatment or inapproproiate treatment often occurs, which leads legitimate patients with other conditions to exhibit many of the "symptoms" of these disorders such as "doctor shopping" and serial ER visitation at different ERs, and extensive self-study of medical literature in order to self-diagnose problems which the patient has not been successful in being correctly diagnosed by professionals, leading to presentation at later/different visits of apparent symptoms of factitious and/or malingering disorders, or even _development_ of factitious disorders in desperate attempts to get a different, legitimate condition addressed correctly.

Doctors and other medical professionals (especially in emergency departments) are often biased toward summary diagnosis of these disorders due to the large number of true factitious/malingering patients they encounter, and once these diagnoses go on a patient's record, it becomes EXTREMELY difficult for them to get accurate diagnoses of other genuine conditions. This can lead patients to exacerbate the misdiagnoses in subsequent visits by engaging, for non-factitious/malingering reasons, in behaviors associated with these conditions, or even to develop a factitious disorder out of true desperation to be relieved of the unbearable symptoms they are experiencing. A good example is fibromyalgia. Until just a few years ago, fibro was overly marginalized by the medical community, and since its discoverry, true malingerers have used it extensively as their "story" to malinger. This clouds and biases true diagnosis under the high-volume, high-stress environment in which medical professionals operate.

"Addictive drug-seeking" is a prime example of a presentation of a desperate patient seeking a correct diagnosis of an extremely painful yet difficult to diagnose condition which is genuinely not factitious/malingering. If one is in extreme pain, the instinctive psychological and physical need to have the pain be stopped, along with multiple misdiagnoses, inappropriate treatments which do not address the instinctive need to have the condition addressed appropriately, and life-preserving (yet damaging) self-medication, can lead a person to do almost all of the things associated with factitious/malingering disorders, even up to the point of inducing these disorders in the patient who can not find appropriate diagnosis and treatment for a different and legitimate condition. They might think "it hurts so much, and they listen so little and do so little to figure it out, I have to come up with a plan to convince them to reduce the symptoms right now, before I kill myself out of desperation, and since they never listen to the truth thanks to b**lsh*t medical records and biases, and therefore continue to diagnose me incorrectly, over and over again, I must study and find a way to convince them of some believable condition that will lead them to treat the unbearable symptoms." Hence, misdiagnosis and institutional bias can CAUSE factitious/malingering behaviors in patients with other, legitimate conditions.

I was such a patient, about 10 years ago. I had a mysterious and apparently undiagnosible condition that caused excruciating pain. It was indescribably awful, and nearly drove me to suicide. I temporarily developed factitious behavior as a result of desperation to have the pain reduced, and to get enough medical attention to diagnose and treat the real disorder, after being summarily dismissed and/or misdiagnosed and mis-medicated to the point of causing further illness several times. I then developed severe alcoholism, and used diverted drugs from "the street" in trying to cope with the pain, which complicated getting a diagnosis of the real condition, which to this day remains a mystery. I stayed "in the system" anyway, during that time, trying to survive and get proper treatment. I found and stayed with a very good GP, and continued to see specialists. I was not trying to get high, or get attention beyond what my recovery required. Eventually my situation resolved, either by itself or through the efforts of expert neurologists and rheumatologists and Traditional Chinese Medicine (acupunture and herbology) specialists, though none of them ever diagnosed my condition fully.

I am now under the care of a psychiatrist (for severe adult ADHD and to learn caregiver skills for a severely mentally-ill family member) who fully agrees that my factitious behavior and self-medication back then were really the only options the establishment left me with, given my situation. I had fully cooperated with the establishment as much as I could, because I wanted to find out what was really wrong and treat it, but I instinctively did what I had to do to survive. I think "factitious" behavior is often the result of neglect by the medical establishment. We do, as humans with a survival instinct, what we have to do to survive.

I have also been in a position where I had to use "factitiousness by proxy" to try to get relief for a family member from severe medical problems that were being misdiagnosed/dismissed, who now, thanks to a good doctor who listens fully and discards pre-bias from our essentially false medical records, has a much more correct and appropriate diagnosis and appropriate treatment regimen for us both. Neither of us have fully recovered either from the original conditions or from the negative ramifications of our previous mistreatment by the medical establishment, but we no longer have to use factitous/malingering-mimicing behaviors to get legitimate treatment of our conditions within the range of conditions this docter treats. We have issues outside of this doctor's specialty range which we are still struggling with, but at least we're getting validation and explantion FROM a doctor about why we have had such a hard time getting legitimate treatment, has empowered us and has enabled us to move forward in treating these other conditions with a better understanding.

Someone who can put all this into correct wording by correct guidelines needs to add this perspective to the articles on factitious/malingering behaviors, as those articles are currently heavily biased against people who are misdiagnosed and/or forced into such behaviors by a medical establishment that is too quick to misdiagnose these conditions and accordingly destroy the quality of life and prognosis of patients with other conditions who present (to their summary and rushed judgment) as having these disorders. I don't dispute the reality of factitious/malingering disorders at all, but it has become a comfortable umbrella for medics to speedily move on to the next patient and avoid controversial things like pain management, admission of their own ignorance (and resulting threat to their credibility) about a given condition, and simply not having enough time and resources to address the true underlying conditions which sometimes present as these disorders, or even CAUSE them. —Preceding unsigned comment added by 24.9.38.104 (talk) 22:28, 21 August 2009 (UTC)

Could you please discuss...

• The external link http://my.clevelandclinic.org/disorders/factitious_disorders/hic_an_overview_of_factitious_disorders.aspx was removed from the article with the edit summary: "unsigned articles on pages with adverts is not good", however, while the article is marked copyright "the cleveland clinic", below that copyright line it offers links to Kathleen Franco, M.D., a psychiatrist, and David Friedman, M.D., a plastic surgeon. My reading of the excised link is that Franco and Friedman are the authors. Barring all references with ads seems questionable to me. Almost all newspaper references contain ads.

• In another recent edit, with the edit summary links should be to scholoarly articles, several links were removed, including: [1] -- which appears to be a reprint of the page about factitious disorder from the DSM-IV -- ie, the Diagnostic and Statistical Manual of Mental Disorders. I suggest that a reprint of the page from the famous DSM-IV meets all the requirement for scholarship.

I call on the contributor who made these excisions to return here and explain why they shouldn't be reverted. Geo Swan (talk) 23:48, 17 September 2009 (UTC)

Factitious Disorder vs Malingering?

Does anyone know the difference between factitious disorder and malingering? From what I've read they appear to be the same...not sure if that is right though. Thanks.

In malingering the purpose of feigning the disease is to get a secondary gain (eg. getting paid for "getting injured at work"). In factitious disorder there is no actually attempt for secondary gain. It is more to get attention of sorts. AriaNo11 (talk) 23:42, 9 September 2010 (UTC)

Two names for the same exact thing, they should be merged. —Preceding unsigned comment added by 147.197.20.137 (talk) 14:54, 23 July 2010 (UTC)

That's false. From DSM-IV: "Factitious Disorders are distinguished from acts of Malingering. In Malingering, the individual also produces the symptoms intentionally, but has a goal that is obviously recognizable when the environmental circumstances are known. For example, the intentional production of symptoms to avoid jury duty … would be classified as Malingering. … In contrast, in Factitious Disorder, the motivation is a psychological need to assume the sick role, as evidenced by an absence of external incentives for the behavior." Cresix (talk) 15:58, 26 October 2010 (UTC)

Absolutely should not be merged

Münchhausen syndrome, factitious disorder and malingering are different disorders. While they may be difficult to differentiate, they are not the same. It is not the purpose of this article to detail these types of disorders but to discuss in detail each particular one. Moreover as Cresix explains in the preceding section above these disorders are different diagnoses based on different DSM-IV criteria. As a result there should be no such talk of merging any of these articles. — Preceding unsigned comment added by AriaNo11 (talk • contribs) 19:47, 10 January 2011 (UTC)

Agreed. Do not merge these articles. —Preceding unsigned comment added by 129.255.1.225 (talk) 09:46, 15 May 2011 (UTC)

Do not merge

Factitious disorders are fundamentally a mental problem, despite the repeated faking of symptoms there is no clear secondary gain. Of the factitious disorders, Munchausens is the most serious of the physical factitious disorders. Malingering is fundamentally different as it is a premeditated fraudulent behaviour for a clear seconday gain. Merging two articles that have two substantially different causes would increase confusion and decrease the clarity of the pages. As another user mentioned above, I also believe that the Cleveland Clinic (as well as the Mayo Clinic) are legitimate sources. — Preceding unsigned comment added by 137.43.188.208 (talk) 13:53, 27 March 2012 (UTC)

Merge template removed

I agree that the articles should not be merged. A consensus has been reached, so I removed the merge template. --momoricks 20:19, 10 April 2012 (UTC)

Added "expert-subject" template

There is uncited information in several sections (including the lead, "Criteria", and "Treatment of Münchausen by proxy") that appears to be incorrect. I added the "expert-subject" because the article needs help and I'm concerned about readers being misinformed --momoricks 20:40, 10 April 2012 (UTC)

"Factitious"

Merrimam Webster has a listing for factitious: "induced by deliberate human action with or without intention to produce a lesion or disease, e.g. factitial rectal lesions following irradiation, a factitial hyperthyroidism resulting from surreptitious ingestion of thyroid products". The first example suggests that it doesn't matter who is creating the lesion/disease, it could be health care professionals during iatrogenic effects of treatment. Lesion (talk) 21:07, 4 May 2013 (UTC)

That's the definition for factitial, the entry right before factitious in Merriam-Webster. This article is about a medical condition named factitious disorder. Stephlet 05:42, 8 April 2015 (UTC) — Preceding unsigned comment added by Stephlet (talk • contribs)

Factitious disorder = ψευδοβουλσίτωσις = pseudobullshitosis

it means pseudo-illness, pseudo-disease

Factitious Andrei Szoke's Pag

"Andrei Szoke's Page to FD", listed under External Sources, does not exist.

Can this be somebody's idea of a joke?

David Lloyd-Jones (talk) 13:12, 23 September 2013 (UTC)

Hi David Lloyd-Jones. It could be a joke, it could be a link that died. I deleted the link. Lova Falk talk 10:09, 6 October 2013 (UTC)

 Fixed