Prevalence of factitious disorder with psychological symptoms in hospitalized patients

Abstract

Factitious disorder is characterized by the invention, production or falsification of physical and psychological symptoms that feign a physical or mental illness. Although it is not rare to find symptoms that seem to be factitious among psychiatric patients (both outpatients and inpatients), we have never been able to confirm this suspicion. Once we had established the suspicion criteria for factitious disorder with psychological symptoms, we discovered that 8% of the patients admitted to an inpatient psychiatric unit had factitious symptoms. The patients were mostly women with a mean age of 36.2 years. The most frequent symptoms were non-consistent response to treatment, worsening of the symptoms when faced with the perspective of a discharge plan, disappearance of the symptoms just after being admitted and intense relationship with other patients or staff during the hospitalization. Although it is not possible to determine the method used in the factitious production of the psychological systems accurately, close observation of the patients helps to infer that 75% of the patients exaggerate the psychological symptoms currently present or those occurring in the past and thus experienced at some time during their lifespan. Invention of psychological symptoms never felt before by the patient and deliberate intervention in the psychiatric treatment to modify the evolution of the illness were less frequent. A total of 25% of the patients with suspicion criteria for factitious disorder with psychological symptoms also had physical symptoms considered to be factitious during the hospitalization and 62% of patients with factitious symptoms developed intense relationships with other patients.