Factitious disorder may also be imposed on another person. Patients may complain of or simulate physical symptoms that suggest certain disorders (eg, abdominal pain suggesting an acute surgical abdomen, hematemesis). Patients often know many associated symptoms and features of the disorder that they are feigning (eg, that pain from an MI may radiate to the left arm or jaw or be accompanied by diaphoresis). Sometimes they simulate or induce physical findings (eg, pricking a finger to contaminate a urine specimen with blood, injecting bacteria under their skin to produce fever or abscess; in such cases, Escherichia coli is often the infecting organism).
Treatment is usually challenging, and there are no clearly effective treatments. Patients may obtain initial relief by having their treatment demands met, but their symptoms typically escalate, ultimately surpassing what physicians are willing or able to do. Confrontation or refusal to meet treatment demands often results in angry reactions, and patients usually move from one physician or hospital to another.