Factitious disorder is a mental illness in which a person makes up an illness or injury. A person with factitious disorder may claim to have the psychological symptoms of a mental illness or the physical symptoms of a medical illness. The term Munchausen syndrome is sometimes used to refer to factitious disorder with severe physical symptoms.
In addition, factitious disorder by proxy (or Munchausen syndrome by proxy) falls into this category. Factitious disorder by proxy involves a parent claiming their child has psychological or physical symptoms in order to get needless medical attention for the child.
Factitious disorder may be confused with another type of mental disorder called somatoform disorder. If a person has this disorder, then they are not pretending to be sick. The person really believes that there is something physically wrong. However, the symptoms are actually due to psychological issues.
Factitious disorder is also different from malingering, which occurs when a person pretends to be sick for some kind of clear benefit, such as money, food, or housing.
People with factitious disorder seek unnecessary medical treatment.
Copyright © Nucleus Medical Media, Inc.
The exact cause of factitious disorder not known. However, it may be a mixture of biological and psychological factors. Some possible causes may include:
- Having frequent illnesses early in life
- Being abused or rejected by a parent
- Identifying with someone who had an illness
Factitious disorder is more common in people who are young or middle aged.
Factors that may increase your risk of factitious disorder include:
Symptoms may include:
- A lengthy, conflicting medical history
- Vague symptoms that did not respond to treatment
- An illness that returns after it is controlled
- Strong knowledge of hospitals and medical terms
- Multiple surgical scars
- New symptoms that appear after test results come back negative
- A medical history at many hospitals, clinics, and doctors’ offices
- Blocking contact between previous and current doctors, and between doctors and family members
- Symptoms that appear only when person is not being observed
- Demanding medical tests or procedures
- Eagerness to have medical tests or procedures
- Self-inflicted or artificial symptoms of disease
It is difficult for a doctor to diagnosis a factitious disorder. People who have this disorder become skillful in pretending to have illnesses. The doctor also has to rule out any real physical condition that the person may have.
If the doctor determines that there is no physical cause for the symptoms, then the person may be referred to a mental health expert. This expert can then rule out other psychological conditions, like somatoform disorder and malingering. The person may become hostile and not want to work with a psychologist. However, there are strategies that the doctor can use to act in a way that is more supportive and helpful. The person can be encouraged to seek mental health treatment.
Factitious disorder is difficult to treat. The person may resist getting help. In some cases, the person may agree to work with a mental health expert. Psychotherapy or behavior therapy may be helpful. If the person has any other conditions, like depression, anxiety, or other mental health problems, these can be treated as well.
There are no current guidelines to prevent factitious disorder.
National Institute of Mental Health
National Mental Health Association
Canadian Mental Health Association
Canadian Psychiatric Association
An overview of factitious disorders. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/an-overview-of-factitious-disorders. Accessed October 4, 2017.
Factitious disorder. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/factitious-disorder. Updated September 28, 2017. Accessed October 4, 2017.
Huffman JC, Stern TA. The diagnosis and treatment of Munchausen syndrome. Gen Hosp Psychiatry. 2003;25(5):358-363.
Münchhausen's syndrome. Patient website. Available at: https://patient.info/doctor/munchhausens-syndrome. Updated November 24, 2014. Accessed October 4, 2017.
Somatic symptom and related disorders. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/somatic-symptom-and-related-disorders/. Updated August 2015. Accessed October 4, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 7/22/2020