Factitious disorder is a mental health condition that involves at least one episode of manufactured or exaggerated physical or mental health symptoms.
Plenty of people have “faked sick” on occasion. You might do it to escape a tough exam, or take a day off work when you have something else you really want to do.
With factitious disorder, though, feigning illness doesn’t bring any benefits. Rather, experts believe this condition mostly relates to a desire for attention and affection, including the positive feelings associated with receiving care from others. A fictitious illness might also offer a way to cope with stress or difficulties in everyday life.
The most recent edition of the “Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)” lists two different types.
- Factitious disorder imposed on self involves presenting yourself as sick or injured, or making yourself ill.
- Factitious disorder imposed on another (by proxy) involves presenting a child, pet, or other loved one as sick or injured, sometimes by actually making them sick.
Falsifying physical or mental health symptoms can certainly earn sympathy and attention from others in the short term. But this condition can eventually affect your physical and emotional health — and making a child, partner, or family member sick translates to abuse.
Here’s what to know about the symptoms and potential causes of factitious disorder, along with tips on getting support.
Factitious disorder vs. Munchausen syndrome
If you’ve come across the term Munchausen syndrome, you might wonder how it differs from factitious disorder.
The short answer: Munchausen syndrome falls under the broader umbrella of factitious disorder, though many healthcare professionals use the terms interchangeably.
Munchausen syndrome most accurately describes factitious disorder that involves:
- mainly physical symptoms
- multiple episodes of feigned illness and injuries
This older term comes from German Cavalry officer Karl Frederick Hieronymus, Frieherr Von Munchausen, who told wildly exaggerated stories about his experiences.
Factitious disorder might involve:
- a reported physical injury, illness, or mental health symptoms that don’t actually exist
- frequent exaggeration of minor health symptoms
- alteration of medical tests or records
Sometimes, this just means describing symptoms you don’t really have, like saying you:
- feel down and depressed or have thoughts of suicide
- feel dizzy and have blurry vision
- have severe back and neck pain
You might:
- share these symptoms anonymously in support groups online
- describe them to friends, loved ones, and co-workers
- make frequent appointments with your healthcare team to pursue testing and treatment
Some people with this condition also create real symptoms by doing things like:
- swallowing cleaning products or other toxic chemicals
- taking medications to prompt diarrhea and vomiting
- introducing dirt, feces, or other unsanitary material into a cut so it becomes infected
- intentionally coming into contact with something that triggers an allergic reaction
- not allowing an injury or surgical site to heal
A 2014 study suggests people with this condition feel unable to stop these behaviors, even when they want to. That’s part of why experts consider factitious disorder a mental health condition.
People with this type of factitious disorder involve someone else in the deception.
They might:
- take a child to doctor after doctor, describing symptoms they don’t actually experience
- tell family members about a teen’s depression, anxiety, and thoughts of self-harm and suicide, when the teen has never mentioned these symptoms
- give a partner food that can cause serious health symptoms — bread if they can’t tolerate gluten, or sugar if they have diabetes
Lying about someone’s health can certainly pose some cause for concern, even if it doesn’t cause direct physical harm.
Purposely making someone sick, however, is abuse. This can make them seriously ill and even lead to death.
Experts don’t know a lot about how common factitious disorder is or what causes it, partly because it can be difficult to identify. Plus, people living with this condition are often reluctant to discuss their symptoms or participate in studies.
The DSM-5 estimates about 1 percent of people receiving inpatient hospital care may meet the diagnostic criteria for factitious disorder. But
While researchers haven’t come to any conclusions about exactly what causes this condition, a few key theories have emerged:
- Serious childhood illness. A history of one or more major illnesses in childhood, especially with symptoms requiring hospitalization, appears to play a part in the development of factitious disorder.
- Childhood trauma or abuse. In a 2014 study, among people seeking support online for this condition, a large percentage reported childhood abuse. Some
2006 evidence also suggests feelings of guilt and a lower self-image as potential contributing factors. Both of these can result from abuse. - Brain development. Research exploring brain chemistry and developmental differences in people with factitious disorder remains limited. That said, some
evidence does suggest a potential link between factitious disorder and differences in brain development, including impaired function in the right cerebral hemisphere.
Other possible risk factors include:
- Age. A 2006 study suggests this condition may be more common in people
between the ages of 20 and 40 . - Gender. In general, both types of factitious disorder more commonly develop in women. But some
evidence also notes that chronic factitious disorder, or Munchausen syndrome, may be more common in men. - Occupation. People with this condition often work in a healthcare or medical field.
- Relationship status. People with this condition tend to be unmarried.
Still, this condition can develop in people of any age and gender. Some
A few other conditions involve symptoms that can resemble factitious disorder.
Malingering
Factitious disorder isn’t the same thing as feigning illness for a clear benefit, like dodging an event, commitment, or task. Experts describe this behavior as malingering. It’s not considered a diagnosable condition, but many experts believe it warrants more exploration.
Malingering means feigning or exaggerating physical or mental health symptoms in order to gain certain benefits, like paid time off work or more time to complete a difficult school exam or project. This behavior generally happens in response to specific circumstances.
On a similar note, anecdotal reports also exist of parents and caregivers fabricating reports of child abuse, during difficult divorce proceedings or for some other reason. Since this behavior happens with a clear goal, it wouldn’t count as factitious disorder imposed on another.
Conversion disorder
This mental health condition involves a pattern of symptoms that affect motor and sensory function. Examples include seizures, difficulty walking or moving muscles, and loss of sensation in parts of your body.
These symptoms:
- don’t align with the presentation of any recognized medical or neurological conditions
- don’t have a clear cause
- affect daily function and cause distress
- may be prompted by an illness or injury
While these symptoms may not have a clear cause or medical explanation, people with this condition actually experience them, often as a result of trauma or other stress. To put it simply, they’re not faking.
Healthcare professionals often recommend a combination of cognitive behavioral therapy (CBT) and physical therapy to treat conversion disorder.
Learn more about conversion disorder.
Somatic symptom disorder
This mental health condition involves a fixation on physical health symptoms.
With somatic symptom disorder, the symptoms — which might include muscle weakness, fatigue, pain, or breathing difficulties — do actually exist. But the extreme concern you feel over these symptoms can lead to significant emotional distress and have a major impact on daily life.
With somatic symptom disorder, you might:
- spend a lot of time worrying about potential causes of symptoms
- experience distress, discomfort, and difficulty functioning as a result of your symptoms
- believe you have a serious or life threatening condition, even when medical testing suggests otherwise
- visit multiple doctors in search of a diagnosis
Treatment for this condition generally involves therapy and regular visits with your healthcare team.
Learn more about somatic symptom disorder.
Unexplained symptoms aren’t necessarily made up
Keep in mind that healthcare professionals can’t always identify medical or mental health conditions right away. What’s more, some people do experience symptoms that don’t follow a recognized pattern.
Other potential concerns that might appear similar to factitious disorder include:
- physical distress related to mental health conditions like anxiety or depression
- physical side effects related to taking or stopping a medication
- extreme parental anxiety and concern about typical childhood ailments
- undiagnosed physical or mental health conditions
Factitious disorder can stem from, and contribute to, significant emotional distress.
If you think you might be experiencing symptoms of factitious disorder, therapy, including CBT, can help.
Rather than confronting or challenging people with factitious disorder, mental health professionals generally focus on offering compassion and working to develop a good therapeutic relationship.
Instead of shaming, judging, or accusing you, they might, for example, acknowledge your feelings of loneliness or need for affection and emotional support.
It’s not at all wrong to want more attention, affection, and sympathy from loved ones, especially when these needs go ignored or unmet. A therapist can offer guidance with exploring more effective ways to communicate your need for support and affection. They might encourage you to include family members in treatment to help accomplish this goal.
In therapy, you can also:
- get support for past trauma or abuse
- learn new ways to cope with stress
- create a self-care checklist
- practice helpful ways to request emotional support
- address underlying mental health symptoms
Factitious disorder symptoms also often improve with treatment for co-occurring mental health conditions, like anxiety, depression, or a personality disorder.
In some cases, a psychiatrist might recommend medication for co-occurring depression or anxiety, but medication doesn’t directly treat factitious disorder.
If you believe a partner, friend, or family member is lying about a mental or physical health concern, confronting them about the behavior generally won’t help.
Remember, factitious disorder is a mental health condition. They may not consciously understand their reasons for making up these symptoms or feel able to stop.
The best option generally involves offering understanding and compassion, without supporting the behavior, and encouraging them to get help from a therapist.
You might try:
- encouraging them to talk with a therapist about any distress their symptoms cause
- asking for updates about their work, hobbies, or pets — not health symptoms
- offering support through affectionate words and kind gestures, or by suggesting activities to try together
- suggesting counseling to work on improving communication and relationship health together
If you suspect a loved one has made you, your child, or someone else sick, it’s best to:
- get medical attention for the sick or injured person
- find a safe space to stay, if necessary
- connect with a legal representative or other advocate to get guidance on what to do next
When it comes to children with factitious disorder, on the other hand, some
When someone talks about self-harm or suicide
Always take mentions of suicide seriously, even if you don’t believe they’ll actually hurt themselves or make a suicide attempt.
Encourage them to get crisis support right away, or help them connect with 24/7 suicide prevention resources:
- Call the National Suicide Prevention Lifeline at 800-273-8255.
- Text HOME to the Crisis Text Line at 741-741.
Get more guidance on supporting a loved one talking about suicide.
Having factitious disorder doesn’t make you a bad person, but there’s no denying it can affect your health, not to mention your relationships.
Getting support from a compassionate therapist can go a long way toward healing. A therapist can help you understand possible factors driving the urge to make up health symptoms, plus learn strategies for changing this behavior.
Crystal Raypole writes for Healthline and Psych Central. Her fields of interest include Japanese translation, cooking, natural sciences, sex positivity, and mental health, along with books, books, and more books. In particular, she’s committed to helping decrease stigma around mental health issues. She lives in Washington with her son and a lovably recalcitrant cat.