What is Factitious disorder?

Factitious Disorder (Munchausen Syndrome)

Factitious disorder, or hospital Addiction disorder or historically known as Munchausen syndrome, is a mental health condition in which a person deliberately creates, exaggerates, or fakes medical symptoms even when they don’t have any actual illness. The main driving force is not financial gain, avoiding work, or other external benefits. Instead, the person has a deep psychological need to receive care, sympathy, and attention, and to feel valued in the role of a patient. Individuals may repeatedly visit hospitals with convincing but false medical histories, and in some cases may harm themselves or, rarely, those dependent on them to maintain the sick role.

The condition was first described in psychiatric literature in the 1950s, and in 1951 the term was introduced by Richard Asher in The Lancet. The name comes from Baron Hieronymus Friedrich von Munchausen, who was known for telling exaggerated stories, similar to how patients may fabricate medical histories.

People with this disorder may simulate illness, create symptoms, or worsen existing medical conditions to receive medical attention. Unlike malingering, where illness is faked for clear external rewards, factitious disorder is driven by internal emotional needs. Over time, this behavior can become extremely dangerous. Repeated hospital admissions, unnecessary tests, surgeries, or medications can cause real physical harm and sometimes life threatening complications. Some individuals have intentionally exposed themselves to infections or medical risks leading to severe outcomes such as sepsis or organ failure. Even though symptoms are intentionally created, these patients still require proper psychiatric care because the emotional distress behind the behavior is genuine.

Course and Prognosis :

Factitious disorder usually begins in early adulthood but can also start in childhood or adolescence. Many individuals have a past history of real illness, hospitalization, or emotional trauma such as loss, rejection, or abandonment. If a person had early hospitalization for genuine illness, the disorder may start earlier than usual. As the condition progresses, patients often become very knowledgeable about medical terms, hospital systems, and treatment procedures, which helps them create believable medical stories. Over time, repeated hospitalizations can severely affect personal relationships, career growth, and social stability. Some individuals may also develop legal issues such as minor crimes or unstable living situations linked to their pattern of behavior.

The overall prognosis is often poor because many patients do not accept psychiatric treatment and continue the cycle of seeking hospital care. Repeated unnecessary medical treatments can lead to severe physical complications, and in rare cases, death may occur due to procedures or medications that were not actually required.

However, certain factors may slightly improve outcomes. These include the presence of depressive or self punishing personality traits, functioning at a borderline level rather than continuous psychosis, and having mild rather than severe antisocial personality traits. Early identification, consistent psychiatric support, and a compassionate, non judgmental healthcare approach can help reduce harm and improve quality of life.