Factitious fever is a heterogeneous pathology based on the simulation, obtained by the patient himself (self-induced fever) or by fraudulent state (feigned fever). Essentially, it refers to an elevated body temperature that is intentionally produced or fabricated by an individual, rather than being caused by an actual illness or medical condition. It is a form of factitious disorder, where individuals deceive others by presenting as ill or injured, or by deliberately causing symptoms.
Understanding the Core Concept
At its heart, factitious fever involves a deliberate act of deception. Unlike malingering, where symptoms are fabricated for external incentives (e.g., financial gain, avoiding work), individuals with factitious fever are often driven by an unconscious psychological need for attention, care, or to assume the sick role.
The "simulation" aspect is crucial here, meaning the individual actively fakes the fever. This can manifest in different ways, leading to the distinction highlighted in the definition:
- Heterogeneous Pathology: This means it's a diverse condition, not a single, uniform way of faking a fever. Various methods can be used to achieve the desired effect.
Two Primary Manifestations of Factitious Fever
The definition points to two main ways factitious fever is "obtained":
1. Self-Induced Fever
This occurs when the patient personally takes action to create the appearance of a fever. The simulation is directly caused by the individual's own efforts.
- How it's achieved:
- Thermometer Manipulation: The most common method involves physically altering the thermometer reading. This can include:
- Placing the thermometer in hot water or near a heat source (e.g., light bulb, heating pad).
- Rubbing the thermometer vigorously to generate friction heat.
- Shaking mercury thermometers to raise the reading.
- Physical Stimulation: Less commonly, individuals might engage in activities that temporarily raise their body temperature, such as:
- Vigorous exercise immediately before temperature measurement.
- Applying hot compresses to the skin where the temperature will be taken.
- Substance Ingestion (Rare/Dangerous): In severe cases, some individuals might ingest substances (e.g., unprescribed medications, contaminants) to induce a physiological response that mimics fever, though this carries significant health risks.
- Thermometer Manipulation: The most common method involves physically altering the thermometer reading. This can include:
2. Feigned Fever (Fraudulent State)
This refers to the broader act of presenting a "fraudulent state" of having a fever. While it can overlap with self-induced methods, it often emphasizes the deceptive presentation of symptoms or data without necessarily performing a direct physical induction of heat.
- How it's achieved:
- Fabricating Symptoms: Verbally reporting symptoms consistent with fever (e.g., chills, sweating, headache, body aches) without actually experiencing them.
- Misrepresenting Readings: Claiming a higher temperature than what was actually measured, or subtly altering documentation of temperature readings.
- Tampering with Records: Altering medical charts or home temperature logs to reflect a persistent fever.
Key Differences and Overlap
While the terms "self-induced" and "feigned" can sometimes be used interchangeably in common parlance, the definition highlights them as distinct pathways to achieving a simulated fever. Self-induced typically refers to the action taken to generate a fake reading, whereas feigned fever encompasses the broader presentation of a fraudulent febrile state. Both fall under the umbrella of factitious fever, as shown in the table below:
| Aspect | Self-Induced Fever | Feigned Fever (Fraudulent State) |
|---|---|---|
| Method | Direct action by the patient to alter temperature | Presenting a false state of having fever, often through deception |
| Focus | Physical manipulation or temporary physiological change | Deceptive communication and misrepresentation |
| Examples | Heating a thermometer, vigorous exercise | Falsely reporting symptoms, fabricating temperature charts |
| Relationship | A specific type or method of simulation | A broader category of fraudulent presentation |
Understanding factitious fever is crucial for healthcare professionals to differentiate it from genuine medical conditions and to address the underlying psychological needs of the individual presenting with it.
