F68.11 Factitious disorder imposed on self, with predominantly psychological signs and symptoms

Name of the Condition

• Factitious Disorder Imposed on Self, with Predominantly Psychological Signs and Symptoms
• ICD-10 Code: F68.11

Summary

This condition involves the intentional production or feigning of psychological symptoms in oneself, without external incentives (e.g., financial gain). The individual may seek medical care or undergo procedures to maintain the sick role, leading to significant impairment in functioning. The behavior is not better explained by another mental disorder and persists despite negative consequences.

Causes

The exact causes are often complex and may involve psychological factors such as a need for attention, emotional distress, or unresolved trauma. Underlying personality traits or maladaptive coping mechanisms may contribute to the development of this disorder.

Risk Factors

• History of trauma or abuse
• Personality disorders (e.g., borderline personality disorder)
• Chronic stress or unstable social environments
• Prior experience with medical care or hospitalization
• Emotional deprivation or neglect during childhood

Symptoms

• Deliberate induction of psychological symptoms (e.g., feigned hallucinations, memory loss)
• Frequent psychiatric evaluations or hospitalizations
• Inconsistent or vague psychological histories
• Evasion of psychiatric evaluation
• Resistance to discharge or treatment
• Pseudologia fantastica (exaggerated or fabricated stories)

Diagnosis

Diagnosis requires a comprehensive psychiatric evaluation, including clinical interviews, behavioral assessments, and review of medical records. The clinician must rule out other mental disorders or physical conditions that could explain the symptoms. The behavior must be intentional and not motivated by external rewards.

Treatment Options

Treatment typically involves psychotherapy, such as cognitive-behavioral therapy, to address underlying psychological needs and maladaptive behaviors. Medications may be prescribed to manage co-occurring conditions like depression or anxiety. Long-term therapy and consistent follow-up are often necessary.

Prognosis and Follow-Up

Prognosis varies, with some individuals showing improvement with sustained treatment, while others may have a chronic course. Regular follow-up with mental health professionals is essential to monitor symptoms and adjust treatment as needed. Early intervention may improve outcomes.

Complications

• Chronic medical or psychiatric complications from unnecessary treatments
• Social isolation or strained relationships
• Financial burden from repeated medical evaluations
• Legal or ethical issues related to deception
• Increased risk of self-harm or suicide

Lifestyle & Prevention

• Building a strong support network of trusted individuals
• Engaging in healthy coping mechanisms (e.g., therapy, exercise)
• Avoiding environments that reinforce the sick role
• Addressing underlying trauma or stressors through professional help
• Maintaining open communication with healthcare providers

When to Seek Professional Help

Seek help if you or someone you know is intentionally producing psychological symptoms, seeking repeated medical care without clear justification, or experiencing significant distress or impairment in daily functioning. Early intervention can improve outcomes.

Tips for Medical Coders

When coding F68.11, ensure documentation clearly indicates the presence of predominantly psychological signs and symptoms (e.g., feigned hallucinations, memory loss) and rules out external incentives. Verify that the behavior is intentional and not better explained by another disorder. Accurate coding requires detailed clinical notes to support the diagnosis.