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Factitious disorders
Other Resources UpToDate PubMed

Factitious disorders

Contributors: Michael W. Winter MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed


Factitious disorders, formerly referred to as Munchausen syndrome, are psychiatric conditions characterized by the self-infliction or misrepresentation of symptoms without an apparent gain or motivation to the affected individual. Clinical presentation can vary widely as patients can appear as injured or ill from any number of diseases, but commonly these patients are high utilizers of the health care system who have symptoms that are not well explained by a known medical condition.

Patients with factitious disorders may have a profound understanding of hospitals, health care systems, and medical language. Reported symptoms are typically severe with vague details about the historical details of their illness or injury.

Many patients will improve during hospital observation but worsen after discharge. Pathological lying and splitting contact between health care providers are common in patients with factitious disorders.

Related topics: facticial dermatitis, factitial panniculitis, factitial ulcer, malingering, medical child abuse, skin popping substance abuse


F68.10 – Factitious disorder imposed on self, unspecified

21586000 – Munchausen's syndrome

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Differential Diagnosis & Pitfalls

  • Malingering – Conscious production of symptoms for recognized gain (as opposed to unrecognized gain by the patient in factitious disorders).
  • Medical child abuse
  • Somatic symptom disorder – Excessive distressing concern about symptoms.
  • Delusional disorder – Belief in an underlying physical illness reaches delusional intensity.
  • Conversion disorder – Unconscious production of symptoms (as opposed to conscious production in factitious disorders).
  • Illness anxiety disorder
The differential diagnosis is broad, but consider disorders with intermittent signs and symptoms, especially rare or uncommon ones. Possibilities include:

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Last Reviewed:06/30/2020
Last Updated:05/09/2023
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Factitious disorders
A medical illustration showing key findings of Factitious disorders : Abdominal pain, Chest pain, Diarrhea, Vomiting, Hematuria, Hypoglycemia, Recurring episodes or relapses, Skin ulcer
Copyright © 2023 VisualDx®. All rights reserved.