Factitious disorder imposed on self
A mental disorder of feigned illness for attention and sympathy.
Factitious disorder imposed on self (FDIS), commonly called Munchausen syndrome, is a complex mental disorder in which an individual imitates symptoms of illness to elicit attention, sympathy, or physical care. Patients intentionally falsify or induce signs and symptoms of illness, trauma, or abuse, performing these actions consciously though possibly unaware of their motivations. The disorder has been recognized since antiquity, with the term 'factitious disease' already in use before 1843 and 'Munchausen syndrome' introduced in 1951, sparking debate over the appropriateness of the name.
- Field
- Psychiatry, Clinical Psychology
- Known for
- Pattern of self-harm where individuals fabricate histories, signs, and symptoms of illness
- Risk factors
- History of childhood trauma, abandonment, serious childhood illness, certain personality disorders; more common in females, middle-aged, healthcare workers
- Diagnosis criteria
- DSM-5 criteria: patient presents as sick motivated by primary gain, evidence of inducing/falsifying symptoms, no alternative explanation
- Related condition
- Factitious disorder imposed on another (Munchausen by proxy)
Lore & Background
The recognition that patients can exaggerate or inflict symptoms on themselves dates to antiquity, with early medical texts describing feigned illness. In 1843, Scots physician Hector Gavin published on the topic, though the term 'factitious disease' was already in use before his work. In the 1930s, psychiatrist Karl Menninger noted some patients compulsively insisted on medically unnecessary surgeries, often seeking a physician with a powerful personality.
Reader's Guide
In 1951, Richard Asher coined 'Munchausen syndrome' in The Lancet, alluding to the fictional Baron Munchausen who told fantastic stories. The name sparked controversy for about fifty years, with objections that a literary allusion was inappropriate given the seriousness of the disease and that it was disrespectful to patients. Some healthcare providers avoid the term because it downplays the complexity of the illness. The more neutral term 'factitious disorder imposed on self' is used interchangeably in practice. Diagnosis is difficult, requiring exclusion of genuine disease through lab tests and clinical assessment by a psychiatrist. Risk factors include childhood trauma, abandonment, serious childhood illness, and certain personality disorders; patients are more likely to be female, middle-aged, and work in healthcare. Common manifestations include intentionally infecting wounds, taking laxatives, or ingesting thyroid medication. A related phenomenon, Munchausen by Internet, involves feigning illness online to garner sympathy, first described in 1998.
Did You Know?
- The term 'Munchausen syndrome' was coined by Richard Asher in a 1951 article in The Lancet.
- The disorder has been recognized since antiquity, with early medical writings describing feigned illness.
- Munchausen by Internet was named in 1998 by psychiatrist Marc Feldman.
More in Psychopathological syndromes 1-24
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