Definition
Factitious disorder is a mental illness in which a person makes up an illness or injury. This is done for emotional reasons. The person may want attention and care. It is not done for money, food, or housing.
There are two types:
- The person claims to be sick or injured
- A parent claims their child is sick or injured —factitious disorder by proxy (Munchausen syndrome by proxy)
People with factitious disorder seek unnecessary medical treatment.
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Causes
The cause of factitious disorder not known. It may be due to brain chemistry and emotional needs.
Risk Factors
This condition is more common in people who are young or middle aged.
Things that may raise the risk are:
- Child abuse or neglect
- Childhood trauma, loss, or illness
- Marriage problems
- Alcohol use disorder or drug abuse
- Stressful life events
- Personality disorders, such as antisocial personality disorder or borderline personality disorder
- Working in healthcare
Symptoms
Symptoms may be:
- Going to many hospitals, clinics, and doctors’ offices
- A long medical history
- Strange symptoms that change often
- An illness that returns after it is controlled
- Strong knowledge of hospitals and medical terms
- New symptoms appear after negative tests
- Blocking contact between:
- Previous and current doctors
- Doctors and family members
- Demanding health tests or procedures
- Causing injury or illness to get attention
Diagnosis
The doctor will ask about symptoms and health history. A physical exam may be done.
It is difficult to diagnose factitious disorder. The doctor has to rule out any real illness. A number of tests may be done. If no illness is found, the doctor may refer the patient to counseling.
Treatment
Factitious disorder is difficult to treat. Some people refuse help. Others may agree to work with a mental health expert.
The goal is to treat the disorder and any other mental health problems. Options may be:
- Counseling and behavior therapy
- Antidepressants—to treat depression and anxiety
Prevention
There are no current guidelines to prevent factitious disorder.
RESOURCES:
National Institute of Mental Health
https://www.nimh.nih.gov
National Mental Health Association
http://www.mentalhealthamerica.net
CANADIAN RESOURCES:
Canadian Mental Health Association
https://cmha.ca
Canadian Psychiatric Association
http://www.cpa-apc.org
REFERENCES:
An overview of factitious disorders. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/an-overview-of-factitious-disorders. Accessed March 11, 2021.
Bass C, Wade DT. Malingering and factitious disorder. Pract Neurol. 2019;19(2):96-105.
Factitious disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/factitious-disorder Accessed March 11, 2021.
Münchhausen's syndrome. Patient website. Available at: https://patient.info/doctor/munchhausens-syndrome. Accessed March 11, 2021.
Somatic symptom and related disorders. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/somatic-symptom-and-related-disorders/. Accessed March 11, 2021.
Last reviewed January 2021 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 3/11/2021
