A Guide to Mental Disorders

Factitious Disorder Imposed On Another

Factitious disorder imposed on another (FDIA), formerly Munchausen syndrome by proxy (MSP), is a mental illness in which a person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick.

What is factitious disorder imposed on another (FDIA)?
When someone has this mental illness, they might act as though their child or dependent has a medical condition that needs attention. However, the child or dependent person isn't sick. People with factitious disorder imposed on another (FDIA) lie about an illness in another person. This other person is usually someone in their care — often a child under the age of 6. In some cases, the dependent person can be another adult, disabled person or an elderly person.

Previously called Munchausen Syndrome by Proxy, factitious disorder imposed on another is one type of factitious disorder. Another type of factitious disorder involves making up false medical conditions about yourself. Factitious disorders are considered mental illnesses because they're associated with severe emotional difficulties.

Whether the false medical claims are about someone else or yourself, this condition can be dangerous. It can lead to unnecessary medical tests and even procedures while the healthcare team tries to figure out what's wrong with the patient. When a child is involved, FDIA is considered a form of child abuse by the American Professional Society on the Abuse of Children.

What is the motivation behind factitious disorder imposed on another?
There may be many different reasons why someone with factitious disorder imposed on another might seek unnecessary medical treatment for a child or dependent. Often, people with FDIA have an inner need for their child (or other dependent person) to be seen as ill or injured. This isn't done to achieve a concrete benefit, like financial gain. It is often done in order to gain the sympathy and special attention given to people who are truly ill and their families.

Who is most likely to have factitious disorder imposed on another (FDIA)?
FDIA is most often seen in mothers — although it can also happen with fathers — who intentionally harm or describe non-existent symptoms in their children to get the attention given to the family of someone who is sick. A person with FDIA uses the many hospitalizations as a way to earn praise from others for their devotion to the child's care, often using the sick child as a means for developing a relationship with the doctor or other healthcare provider.

There are certain characteristics that are common in a person with FDIA, including:
- Being a parent, usually a mother, but the person can also be the adult child of an elderly patient, spouse or caretaker of a disabled adult.
- Sometimes being a healthcare professional or having medical knowledge.
- Being very friendly and cooperative with the healthcare providers.
- Appearing to be quite concerned — some might seem overly concerned — about their child or designated patient.
- Possibly also suffering from factitious disorder imposed on self. This is a related disorder in which the caregiver repeatedly acts as if he or she has a physical or mental illness when he or she has caused the symptoms.

How common is factitious disorder imposed on another (FDIA)?
There are no reliable statistics regarding the number of people in the United States who suffer from FDIA, and it is difficult to assess how common the disorder is because many cases go undetected. However, estimates suggest that about 1,000 of the 2.5 million cases of child abuse reported annually are related to FDIA.

In general, FDIA occurs more often in women than in men.

Was factitious disorder imposed on another (FDIA) previously called Munchausen syndrome by proxy?
Yes. In the past, factitious disorder imposed on another (FDIA) was called Munchausen syndrome by proxy. This name referred to a figure named Baron Munchausen who was known for exaggerated stories. The change from Munchausen syndrome by proxy to factitious disorder imposed on another provides a more accurate description of a person's behavior. This new name is more specific.