Factitious

Factitious is an adjective meaning artificially created or deceptive. In medicine, it refers to the feigning or fabrication of medical or psychological symptoms, or the induction of injury or illness, to assume the sick role rather than for external gain. Factitious disorder (also historically called Munchausen syndrome) is a mental disorder diagnosed when a person deliberately produces, feigns, or exaggerates symptoms without obvious external incentives. When the deceptive behavior is directed at another person, usually a dependent such as a child or elder, the condition is called factitious disorder imposed on another (previously Munchausen syndrome by proxy).

People with factitious disorder may present with nonspecific symptoms, undergo extensive medical testing, and report severe symptoms that are inconsistent with objective findings. The diagnosis is challenging and rests on careful history-taking, observation, and ruling out true medical conditions; there are no definitive laboratory tests. Distinguishing factitious disorder from malingering (where there are external incentives such as money, shelter, or avoiding work) is essential but not always straightforward.

Causes are not fully understood, but risk factors include a desire for attention or sympathy, extensive medical knowledge, and disturbances in self-image; comorbidity with personality disorders has been observed. Treatment focuses on establishing a therapeutic alliance, minimizing unnecessary procedures, and addressing psychosocial needs; patients may resist, and there is limited evidence for specific pharmacologic therapies. In cases of factitious disorder imposed on another, protecting the affected person is a priority and may involve legal and social services interventions.