- Related Resources - Mental Health: Factitious Disorders
- Phobias Slideshow Pictures
- Depression Tips Slideshow
- Top Concentration Killers Slideshow
- Find a local Psychiatrist in your town
- Types of factitious disorders
- What are the symptoms of factitious disorders?
- What causes factitious disorders?
- How common are factitious disorders?
- How are factitious disorders diagnosed?
- How are factitious disorders treated?
- What is the prognosis for people with factitious disorders?
- Can factitious disorders be prevented?
Factitious disorders are conditions in which a person acts as if he or she has a physical or mental illness when he or she is not really sick. Factitious disorder by proxy is when a person acts as if a person in their care has an illness when they do not.
People with factitious disorders deliberately create or exaggerate symptoms of an illness in several ways. They may lie about or fake symptoms, hurt themselves to bring on symptoms, or alter tests (such as contaminating a urine sample) to make it look like they or the person in their care are sick.
People with factitious disorders behave this way because of an inner need to be seen as ill or injured, not to achieve a clear benefit, such as financial gain. People with factitious disorders are even willing and sometimes eager to undergo painful or risky tests and operations in order to obtain the sympathy and special attention given to people who are truly ill or have a loved one who is ill. Factitious disorders are considered mental illnesses because they are associated with severe emotional difficulties.
Many people with factitious disorders also suffer from other mental conditions, particularly personality disorders. People with personality disorders have long-standing patterns of thinking and acting that differ from what society considers usual or normal. These people generally also have poor coping skills and problems forming healthy relationships.
Factitious disorders are similar to another group of mental disorders called somatoform disorders, which also involve the presence of symptoms that are not due to actual physical or mental illnesses. The main difference between the two groups of disorders is that people with somatoform disorders do not fake symptoms or mislead others about their symptoms on purpose.
Types of Factitious Disorders
There are four main types of factitious disorders, including:
- Factitious disorder with mostly psychological symptoms: As the description implies, people with this disorder mimic behavior that is typical of a mental illness, such as schizophrenia. They may appear confused, make absurd statements and report hallucinations, the experience of sensing things that are not there; for example, hearing voices. Ganser syndrome, sometimes called prison psychosis, is a factitious disorder that was first observed in prisoners. People with Ganser syndrome have short-term episodes of bizarre behavior similar to that shown by people with serious mental illnesses.
- Factitious disorder with mostly physical symptoms: People with this disorder claim to have symptoms related to a physical illness, such as symptoms of chest pain, stomach problems, or fever. This disorder is sometimes referred to as Munchausen syndrome, named for Baron von Munchausen, an 18th century German officer who was known for embellishing the stories of his life and experiences.
- Factitious disorder with both psychological and physical symptoms: People with this disorder produce symptoms of both physical and mental illness.
- Factitious disorder not otherwise specified: This type includes a disorder called factitious disorder by proxy (also called Munchausen syndrome by proxy). People with this disorder produce or fabricate symptoms of illness in another person under their care. It most often occurs in mothers (although it can occur in fathers) who intentionally harm their children in order to receive attention.
What Are the Symptoms of Factitious Disorders?
Possible warning signs of factitious disorders include:
- Dramatic but inconsistent medical history
- Unclear symptoms that are not controllable and that become more severe or change once treatment has begun
- Predictable relapses following improvement in the condition
- Extensive knowledge of hospitals and/or medical terminology, as well as the textbook descriptions of illness
- Presence of many surgical scars
- Appearance of new or additional symptoms following negative test results
- Presence of symptoms only when the patient is with others or being observed
- Willingness or eagerness to have medical tests, operations, or other procedures
- History of seeking treatment at many hospitals, clinics, and doctors offices, possibly even in different cities
- Reluctance by the patient to allow health care professionals to meet with or talk to family members, friends, and prior doctors
What Causes Factitious Disorders?
The exact cause of factitious disorders is not known, but researchers are looking at the roles of biological and psychological factors in the development of these disorders. Some theories suggest that a history of abuse or neglect as a child, or a history of frequent illnesses that required hospitalization might be factors in the development of the disorder.
How Common Are Factitious Disorders?
There are no reliable statistics regarding the number of people in the U.S. who suffer from factitious disorders. Obtaining accurate statistics is difficult because dishonesty is common with this condition. In addition, people with factitious disorders tend to seek treatment at many different health care facilities, which can lead to statistics that are misleading.
In general, factitious disorders are more common in men than in women. However, factitious disorder by proxy tends to be more common in women than in men.
How Are Factitious Disorders Diagnosed?
Diagnosing factitious disorders is very difficult because of, again, the dishonesty that is involved. Doctors must rule out other possible physical and mental illnesses before a diagnosis of factitious disorder can be considered.
If the doctor finds no physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a factitious disorder. The doctor bases his or her diagnosis on the exclusion of actual physical or mental illness, and his or her observation of the person's attitude and behavior.
How Are Factitious Disorders Treated?
The first goal of treatment for a factitious disorder is to modify the person's behavior and reduce his or her misuse or overuse of medical resources. In the case of factitious disorder by proxy, the main goal is to ensure the safety and protection of any real or potential victims. Once the initial goal is met, treatment aims to work out any underlying psychological issues that may be causing the person's behavior.
The primary treatment for factitious disorders is psychotherapy (a type of counseling). Treatment likely will focus on changing the thinking and behavior of the individual with the disorder (cognitive-behavioral therapy). Family therapy may also be helpful in teaching family members not to reward or reinforce the behavior of the person with the disorder.
There are no medications to treat factitious disorders themselves. Medication may be used, however, to treat any related disorder -- such as depression, anxiety, or a personality disorder. The use of medications must be carefully monitored in people with factitious disorders due to the risk that the drugs may be used in a harmful way.
- Americans Getting More Comfortable Talking Over Mental Health With Doctors
- Surge in Severe Strep Cases in Kids Was Really a Return to Normal: CDC
- For Baby's Sake, Moms-to-Be Need the Whooping Cough Vaccine: CDC
- Flu Shot Could Be a Lifesaver for Folks With Chronic Ills
- Long COVID Risk May Be Especially High for Cancer Patients
- More Health News »
What Is the Outlook for People with Factitious Disorders?
People with factitious disorders are at risk for health problems (or even death) associated with hurting themselves or otherwise causing symptoms. In addition, they may suffer from reactions or health problems related to multiple tests, procedures, and treatments; and are at high risk for substance abuse and attempts at suicide. A complication of factitious disorder by proxy is the abuse and potential death of the victims.
Because many people with factitious disorders deny they are faking symptoms and will not seek or follow treatment, recovery is dependent on a doctor or loved one identifying or suspecting the condition in the person and encouraging them to receive proper medical care for their disorder and stick with it.
Some people with factitious disorders suffer one or two brief episodes of symptoms and then get better. In most cases, however, the factitious disorder is a chronic, or long-term, condition that can be very difficult to treat.
Can Factitious Disorders Be Prevented?
There is no known way to prevent factitious disorders.
WebMD Medical Reference
Health Solutions From Our Sponsors
Mayo Clinic: "Munchausen syndrome."
Medscape: "Factitious Disorder."
Disorders.org: "Factitious Disorders."
Reviewed by Joseph Goldberg, MD on May 31, 2012
Top Factitious Disorders Related Articles
Alcoholism and Alcohol AbuseAlcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It can cause myriad health problems, including cirrhosis of the liver, birth defects, heart disease, stroke, psychological problems, and dementia. Counseling and a few medications can be effective for alcoholism treatment.
AnxietyAnxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
CancerCancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
DepressionDepression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Learn to Spot Depression: Symptoms, Warning Signs, MedicationKnow when you or someone else is depressed. Get information on depression symptoms, signs, tests, and treatments for many types of depression chronic depression and postpartum depression.
Drug AbuseDrug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
Mental HealthMental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy and medication.
Mental Illness in ChildrenAbout 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
Myths and Facts About Depression SlideshowFolk remedies and half-truths still prevent many from getting treatment for depression. WebMD's pictures show unusual symptoms in men, seniors, and others, along with many ways to recover.
ScarsScar formation is a natural part of the healing process after injury. The depth and size of the wound incision and the location of the injury impact the scar's characteristics, but your age, heredity and even sex or ethnicity will affect how your skin reacts.
SchizophreniaSchizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
SuicideSuicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.