Tests and diagnosis

By Mayo Clinic Staff

Diagnosing factitious disorder is often extremely difficult. People with factitious disorder are experts at faking many different diseases and conditions. And often they do have real and even life-threatening medical conditions, even though these conditions may be self-inflicted.

The person's use of multiple health care providers and hospitals, the use of a fake name, and privacy and confidentiality regulations may make gathering information about previous medical experiences difficult or even impossible.

A health care provider may suspect factitious disorder when:

  • The person's medical history doesn't make sense
  • No believable reason exists for the presence of an illness or injury
  • The illness does not follow the usual course
  • There is a lack of healing for no apparent reason, despite appropriate treatment
  • There are contradictory or inconsistent symptoms or lab test results
  • The person is caught in the act of lying or causing his or her injury

To help determine if someone has factitious disorder, mental health providers conduct a detailed interview and run tests for possible physical problems.

To be diagnosed with factitious disorder, a person must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. The DSM criteria for factitious disorder (previously, when severe, called Munchausen syndrome) include:

  • Making up physical or psychological signs or symptoms or causing injury or disease with the deliberate intention to deceive
  • Pretending to be sick or injured or to be having problems functioning
  • Continuing with the deception, even without receiving any visible benefit or reward
  • Behavior is not better explained by another mental disorder, such as a delusional disorder or another psychotic disorder

The DSM criteria for factitious disorder imposed on another (previously called Munchausen syndrome by proxy) include:

  • Making up physical or psychological signs or symptoms or causing injury or disease in another person with the intention to deceive
  • Presenting another person to others as sick, injured or having problems functioning
  • Continuing with the deception, even without receiving any visible benefit or reward
  • Behavior is not better explained by another mental disorder
May. 02, 2014

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