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
Factitious disorders
Alerts and Notices
Synopsis
Codes
ICD10CM:
F68.10 – Factitious disorder imposed on self, unspecified
SNOMEDCT:
21586000 – Munchausen's syndrome
F68.10 – Factitious disorder imposed on self, unspecified
SNOMEDCT:
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
- Heavy metal poisoning
- Wilson disease
- Hemochromatosis
- Familial Mediterranean fever
- Hemophilia
- Epilepsy
- Inherited or acquired immune deficiency syndromes
- Mitochondrial disorders
- Substance use disorders (see addiction disorders)
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Last Reviewed:06/30/2020
Last Updated:05/09/2023
Last Updated:05/09/2023