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.
Receiving Medical Treatment
People with factitious disorder seek unnecessary medical treatment.
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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 lifeBeing abused or rejected by a parentIdentifying 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:
Having a personality disorder, such as
antisocial personality disorder
borderline personality disorderHaving severe problems during childhood such as psychiatric problemsBeing hospitalized or institutionalizedHaving a poor sense of identityHaving poor coping skillsWorking in the healthcare field
Symptoms may include: A lengthy, conflicting medical historyVague symptoms that did not respond to treatmentA illness that returns after it is controlledStrong knowledge of hospitals and medical termsMultiple surgical scarsNew symptoms that appear after test results come back negativeA medical history at many hospitals, clinics, and doctors’ officesBlocking contact between previous and current doctors, and between doctors and family membersSymptoms that appear only when person is not being observedDemanding medical tests or proceduresEagerness to have medical tests or proceduresSelf-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
other mental health problems, these can be treated as well.
There are no current guidelines to prevent factitious disorder.
Factitious disorders. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/health/diseases_conditions/hic_An_Overview_of_Factitious_Disorders. Updated June 11, 2013. Accessed October 13, 2015.
Huffman JC, Stern TA. The diagnosis and treatment of Munchausen syndrome.
Gen Hosp Psychiatry. 2003;25(5):358-363.
Munchausen's syndrome. Patient UK website. Available at:
http://patient.info/doctor/munchhausens-syndrome. Updated November 24, 2014. Accessed October 13, 2015.
Somatic symptom and related disorders. American Academy of Family Physicians Family Doctor website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/somatoform-disorders.html. Updated August 2015. Accessed October 15, 2015.
Last reviewed August 2015 by Adrian Preda, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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