Merck Manual

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Factitious Disorder Imposed on Another


Joel E. Dimsdale

, MD, University of California, San Diego

Last review/revision Aug 2022 | Modified Sep 2022
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Factitious disorder imposed on another is falsification of manifestations of an illness in another person, typically done by caregivers to someone in their care.

Previously, this disorder was known as factitious disorder by proxy or Munchausen syndrome by proxy. In factitious disorder imposed on another, people, usually caregivers (such as a parent), intentionally produce or falsify physical or psychologic symptoms or signs in a person in their care (usually a child), rather than in themselves (as in factitious disorder imposed on self).

The caregiver falsifies history and may injure the child with drugs or other agents or add blood or bacterial contaminants to urine specimens to simulate disease. The caregiver seeks medical care for the child and appears to be deeply concerned and protective. The child typically has a history of frequent hospitalizations, usually for a variety of nonspecific symptoms, but no firm diagnosis. Victimized children may be seriously ill and sometimes die.

Factitious disorder imposed on another is typically difficult to recognize, particularly when the caregiver's history is plausible (eg, report of a fever in an infant) and/or the victimized person is nonverbal.

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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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