Preparing for your appointment

A person with factitious disorder is likely to first receive care for this condition when a doctor raises concerns that psychological problems may be a factor in the illness. If your loved one has symptoms that suggest factitious disorder, his or her doctor may contact you in advance to talk about your loved one's health history.

If you think a loved one may have factitious disorder, contact his or her doctor and start the conversation yourself. Here's some information to help you get ready for that talk.

What you can do

To get prepared, make a list of:

  • Your loved one's health history in as much detail as possible. Include health complaints, diagnoses, medical treatments and procedures. If possible, bring the names and contact information of health care professionals or facilities that provided care. Be prepared to help your loved one sign releases of information to get records and allow for conversations with other health care professionals.
  • Any current behaviors or circumstances you observe that cause you to be concerned that your loved one may have factitious disorder.
  • Key points from your loved one's personal history, including abuse or other trauma that occurred during childhood and any significant recent losses.
  • Medications your loved one currently takes, including supplements and over-the-counter and prescription drugs, and the dosages.
  • Your questions for the doctor so that you can make the most of your discussion.

For factitious disorder, some questions to ask the doctor include:

  • What is likely causing my loved one's symptoms or condition?
  • Are there other possible causes?
  • How will you determine the diagnosis?
  • Is this condition likely temporary or long lasting?
  • What treatments are recommended for this disorder?
  • How much do you expect treatment could improve the symptoms?
  • How will you monitor my loved one's well-being over time?
  • Do you think family therapy will be helpful in this case?
  • What next steps should we take?

What to expect from the doctor

The doctor is likely to ask you a number of questions, including:

  • What injuries or illnesses has your loved one recently complained of or been treated for in the past?
  • Has your loved one been diagnosed with any specific medical problem?
  • What treatments has he or she had, including drugs and surgery?
  • How often has your loved one changed doctors or hospitals in the past?
  • Have any doctors, friends or family had concerns that your loved one may be causing or contributing to his or her own illness?
  • Have any doctors, friends or family had concerns that your loved one may be causing or contributing to illness in another person?
  • How have your loved one's symptoms affected his or her career and personal relationships?
  • Do you know if he or she ever had a self-inflicted injury or attempted suicide?
  • Did he or she suffer any other trauma during childhood, such as a serious illness, loss of a parent or abuse?
  • Have you talked to your loved one about your concerns?
May 31, 2017
References
  1. Factitious disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Jan. 31, 2017.
  2. Factitious disorder imposed on self. Merck Manual Professional Version. http://www.merckmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/factitious-disorder-imposed-on-self. Accessed Jan. 31, 2017.
  3. Yates GP, et al. Factitious disorder: A systematic review of 455 cases in the professional literature. General Hospital Psychiatry. 2016;41:20.
  4. Irwin MR, et al. Factitious disorder imposed on self (Munchausen syndrome). http://www.uptodate.com/home. Accessed Jan. 31, 2107.
  5. Ferri FF. Factitious disorder (including Munchausen syndrome). In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. http://www.clinicalkey.com. Accessed Jan. 31, 2017.
  6. Marx JA, et al., eds. Factitious disorders and malingering. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Jan. 31, 2017.
  7. Kahn A, et al. Factitious disorder in Crohn's disease: Recurrent pancytopenia caused by surreptitious ingestion of 6-mercaptopurine. Case Reports in Gastroenterology. 2015;9:137.
  8. Jones TW, et al. Factitious disorder-by-proxy simulating fetal growth restriction. Obstetrics and Gynecology. 2015;125:732.
  9. Burton MC, et al. Munchausen syndrome by adult proxy: A review of the literature. Journal of Hospital Medicine. 2015;10:32.
  10. Sawchuk CN (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 28, 2017.