DSM–5 and DSM-5-TR divide Factitious disorder into two subtypes characterized by (a) the falsification of symptoms or induction of injury or disease imposed on oneself (Factitious disorder imposed on self), and (b) the same deceptions or harm imposed on others (Factitious disorder imposed on another). The latter is synonymous with Factitious disorder by proxy, previously called Münchausen syndrome by proxy.
Factitious Disorder Imposed on Another
Previously called Factitious Disorder by Proxy, or Munchausen Syndrome by Proxy.
Criterion A
Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception.
Criterion B
The individual presents another individual (victim) to others as ill, impaired, or injured.
Criterion C
The deceptive behavior is evident even in the absence of obvious external rewards.
Criterion D
The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.
Note: The perpetrator, not the victim, receives this diagnosis.
The prevalence of factitious disorder is unknown, since the disorder involves deception; in hospital settings, it is estimated that up to 1% may meet criteria for factitious disorder.
Factitious disorder is more common in women and healthcare workers.
In Factitious disorder imposed on another (FDIA, or Munchausen syndrome by proxy) almost all perpetrators are female, and more than 95% of perpetrators are the mother.
Patients may have a history of abuse or neglect as a child, experienced a true medical condition that led to extensive treatment in childhood, past important relationships with a physician, or may have underlying malicious intent towards the medical profession.
Comorbidity
Personality disorders are common in factitious disorder.
In Factitious disorder imposed on another (FDIA), there is also high comorbidity with personality disorders, Somatoform disorders, and mood disorders in the perpetrator.