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
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.
Having severe problems during childhood such as psychiatric problems
Being hospitalized or institutionalized
Having a poor sense of identity
Having poor coping skills
Working in the healthcare field
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
anxiety, or other mental health problems, these can be treated as well.
There are no current guidelines to prevent factitious disorder.
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
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