Factitious Disorder: Psychopathology, Psychometrics, Psychotherapy, Pharmacotherapy

Introduction: Factitious Disorder (FD), a complex and challenging condition, is characterized by the intentional production of physical or psychological symptoms without obvious external gain, the primary motivator being the need to assume the sick role [1]. This disorder, often underdiagnosed, poses significant challenges to clinical practice and healthcare systems [2].Objective: This article aims to analyze a clinical case of Factitious Disorder, exploring its psychopathological manifestations, psychometric findings, and therapeutic approaches, in order to deepen understanding of the complex interaction among psychological, biological, and social factors [3].Methodology: We present the case of M.C.L., a 38-year-old nursing technician with a history of multiple hospitalizations and inconsistent medical complaints, culminating in the feigning of clinical conditions [4]. The investigation included a detailed medical history, laboratory exams, and an in-depth analysis of the Rorschach protocol, interpreted from multiple psychopathological perspectives [5].Results: The patient exhibited a pattern of behavior compatible with Factitious Disorder, exacerbated by a premorbid personality (hyperactivity, bodily narcissism, hysteria) and hormonal imbalances (long-term use of progestogens and climacteric) [6]. Rorschach analysis revealed borderline and hysterical personality traits, with raw emotionality, interpersonal difficulties, and a tense, fabulatory mind marked by terrifying symbolic content and cognitive disorganization, despite the absence of clinical psychosis [7]. The findings indicate that “pathological energy” may have a biological origin that fuels a psychodynamic system altered by dysfunctional family experiences, contrasting with the purely psychogenetic view of classical psychoanalysis [8].Conclusion: The case of M.C.L. illustrates the multifactorial nature of Factitious Disorder and the inadequacy of therapeutic approaches relying solely on pharmacology or isolated psychodynamic methods [9]. Effective management requires an integrated biopsychosocial understanding, combining pharmacotherapy aimed at comorbidities and biological (hormonal) stabilization with psychotherapeutic interventions addressing underlying personality structure and relational conflicts [10].