Somatic symptom and related disorders
Factitious Disorder
Factitious disorder involves falsifying physical or psychological signs, inducing injury or illness and presenting oneself—or another person—as ill, injured or impaired.
Two presentations, different safety priorities
When imposed on self, a person may report false symptoms, alter samples, interfere with wounds or induce illness. When imposed on another, someone falsifies or causes symptoms in another person and presents them as a patient. In the second presentation, the diagnosis applies to the perpetrator while the person targeted is assessed for abuse and any genuine illness.
The behaviour can occur without an obvious external reward, but motives are often complex and clinicians do not need to guess one. Real illness can coexist with fabrication and must still receive appropriate care.
Evidence and assessment
- There is falsification of symptoms or induction of injury or disease with identifiable deception, not simply unexplained symptoms or an incorrect history.
- Objective records may show clinically important inconsistencies, interference with tests or treatment, or a pattern across fragmented services.
- Delusional and other psychotic explanations, substance effects, genuine disease and misunderstanding are assessed before conclusions are drawn.
- When another person may be harmed, independent medical assessment, documentation and safeguarding take priority over confronting the suspected perpetrator.
Coordinated care
A lead clinician and accurate shared record can reduce duplicated tests and dangerous fragmentation while respecting privacy and legal requirements. The team treats genuine disease, limits unnecessary procedures and maintains clear, non-humiliating boundaries.
Psychotherapy may address coexisting distress and dangerous behaviour, but response varies. In cases imposed on another, treatment offered to the suspected perpetrator never replaces protection, independent examination and continuing monitoring of the possible victim.
Safeguarding action
Professionals should document objective evidence, coordinate multidisciplinary review and follow safeguarding law rather than investigating alone. If a child, older person or dependent adult may be poisoned, injured, subjected to unnecessary procedures or blocked from safe care, immediate medical and protective intervention is required.