What is a factitious disorder?

Factitious disorder imposed on self (FDIS), more commonly known as Munchausen syndrome, is a medical condition when a person lies and deceives others by pretending to have an illness. People with this disorder are aware they are pretending and are motivated by a need for attention and care. It is complicated and difficult to diagnose and treat.

Symptoms

According to the Mayo Clinic, people with this disorder present with symptoms such as:

• Exaggerating or lying about health “symptoms” 
• Frequent visits to hospitals
• Large knowledge of medical terms and conditions
• Inconsistent symptoms
• Medical treatment unresponsive or worsen imaginary symptoms

These put a person with FDIS at risk through unnecessary procedures and surgeries that could negatively affect their lives.

There is not one clear and concrete cause of FDIS. Most doctors link it to childhood trauma—such as abuse and neglect—or even a personality disorder like anti-social or borderline. 

FDIS … but imposed on another person

According to the Cleveland Clinic, factitious disorder imposed on another (FDIA) is the second subtype under factitious disorders, described as falsely claiming that someone under your care is in need of medical attention. This usually takes the form of a caretaker to a child.

It also presents with most of the same symptoms of FDIS, except inflicted onto someone else. This may look like:

• A parent physically harming their child to give the appearance of sickness 
• Making up lab and test results
• Tampering with treatment in order to extend and worsen an imagined illness

They are motivated by a need for control in their lives. Caretakers with FDIA appear to always be by their child’s side, giving them easy access to fake symptoms.

PubMed Central reports that FDIA can be considered a form of child abuse in a parent-to-child scenario. It sparks the debate of whether it should be treated like any other medical condition—with understanding and care—or if being diagnosed is proof of being guilty for child abuse.

Diagnosis and treatment

The National Health Service states that factitious disorders are poorly understood, so diagnosis becomes a tedious process. 

As a result of the deceitful tendencies of patients, most doctors are only able to diagnose the condition through basic procedures like lab and imagery testing, family history, and physical examinations. Attempting to confront the patient with accusations of having FDIS(A) may cause them to deny it and refuse treatment.

When those don’t provide sufficient results, doctors turn to other methods. For example, they may get one doctor to gain the trust of a patient with the disorder so that they can get information or an admission of their illness. From there, a person with FDIS may go through therapy to manage symptoms and function better.

Conclusion

Overall, factitious disorders are not to be taken lightly. You might be inclined to believe that anyone who pretends to have an illness has it, but it is more than that; the length that people will go to convince others they have an illness can make them a danger to themselves and others. 

A better understanding of the disorder can help medical professionals recognize when a factitious disorder is present, particularly in FDIA, where one party is being abused.