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Malingering, factitious disorders and somatoform disorders: Pathology review
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Munchausen syndrome by proxy p. 589
Tanner Marshall, MS
Factitious disorder, which is sometimes called Munchausen syndrome, is where an individual fabricates or exaggerates physical or psychological symptoms because they enjoy being in the “sick role”.
These symptoms are sometimes faked but may also be induced; for example, a person with factitious disorder might purposefully ingest something to induce vomiting.
Factitious disorder is listed in the DSM-5 as a somatic symptom disorder.
But unlike other disorders in that group, individuals don’t experience any symptoms, nor are they concerned that they will develop any symptoms.
Factitious disorder can happen as a single episode, but generally individuals have recurrent hospitalizations and are very knowledgeable about the symptoms they are trying to pass off as real.
Individuals with factitious disorder are generally motivated by the attention and sympathy that they receive when pretending to be sick.
These motivations are often subconscious, which is to say that individuals often don’t even realize why they fabricate their symptoms.
Importantly, individuals with this disorder are usually not faking their symptoms for money, time off of work, access to medications, or any other obvious external reward; if this were the case, it’d be a psychological condition known as malingering.
A related diagnosis is “factitious disorder imposed on another” which is also called factitious disorder by proxy or Munchausen syndrome by proxy.
In this form of the disorder, one person deliberately makes a second person ill without that person’s knowledge.
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