Factitious Disorder

About Factitious Disorder

Factitious disorder involves falsifying physical or psychological signs or symptoms, or inducing injury or disease, in association with identified deception, in the absence of obvious external rewards such as money or avoiding work. This lack of external incentive distinguishes it from malingering. DSM-5 describes factitious disorder imposed on self and factitious disorder imposed on another, previously called factitious disorder by proxy, in which a person falsifies illness in someone else, often a child, which is also a form of abuse. Behaviors may include exaggerating or fabricating symptoms, tampering with test results, taking substances to produce symptoms, or causing wounds or infections. Severe chronic forms were historically known as Munchausen syndrome, a name given by the British physician Richard Asher in 1951 after a fictional baron known for telling tall tales. People with the condition may undergo many unnecessary tests, procedures and hospitalizations, and it can cause serious harm. The underlying motivations are not fully understood but may involve a need to take on the role of a patient. Diagnosis is difficult and often depends on careful review of records. Management usually emphasizes coordinated care among clinicians, minimizing harmful interventions, and a nonpunitive approach that offers psychological treatment, though many people do not engage in it. Protection of others is the priority when the disorder is imposed on another.