F68.A Factitious disorder imposed on another

Name of the Condition

• Factitious Disorder Imposed on Another
• ICD-10 Code: F68.A

Summary

This condition involves the intentional production or feigning of physical or psychological symptoms in another person, typically a dependent (e.g., a child), without external incentives (e.g., financial gain). The individual may manipulate or induce symptoms in the victim to assume the sick role, leading to significant impairment in the victim's functioning. The behavior is not better explained by another mental disorder and persists despite negative consequences.

Causes

The exact causes are often complex and may involve psychological factors such as a need for attention, emotional distress, or unresolved trauma. Underlying personality traits or maladaptive coping mechanisms may contribute to the development of this disorder.

Risk Factors

• History of trauma or abuse
• Personality disorders (e.g., borderline personality disorder)
• Chronic stress or unstable social environments
• Prior experience with medical care or hospitalization
• Emotional deprivation or neglect during childhood

Symptoms

• Deliberate induction of symptoms in another person (e.g., medication manipulation, fabrication of illnesses)
• Frequent medical visits or hospitalizations for the victim
• Inconsistent or vague medical histories provided by the perpetrator
• Evasion of psychiatric evaluation for the perpetrator
• Resistance to discharge or treatment for the victim
• Pseudologia fantastica (exaggerated or fabricated stories by the perpetrator)

Diagnosis

Diagnosis typically involves a comprehensive psychiatric evaluation of the perpetrator, including clinical interviews, behavioral assessments, and reviewing life history. Collateral information from the victim, family, or medical records is critical to confirm the intentional induction of symptoms.

Treatment Options

Treatment often includes psychotherapy (e.g., cognitive-behavioral therapy) to address underlying psychological factors and maladaptive behaviors. In severe cases, psychiatric hospitalization may be necessary to ensure the safety of the victim and provide intensive intervention for the perpetrator.

Prognosis and Follow-Up

Prognosis varies depending on the severity of the disorder, the perpetrator's willingness to engage in treatment, and the extent of harm to the victim. Long-term follow-up is essential to monitor for recurrence and ensure the victim's ongoing safety and well-being.

Complications

• Severe physical or psychological harm to the victim
• Chronic medical issues due to unnecessary treatments
• Legal or social consequences for the perpetrator
• Long-term psychological trauma for the victim

Lifestyle & Prevention

• Educate caregivers and healthcare providers about the signs of factitious disorder imposed on another.
• Encourage open communication and support for individuals with a history of trauma or mental health conditions.
• Monitor high-risk situations (e.g., frequent medical visits, inconsistent histories) and report concerns to appropriate authorities.

When to Seek Professional Help

Seek immediate professional help if you suspect someone is intentionally inducing symptoms in another person, especially in vulnerable individuals (e.g., children, elderly). Contact a healthcare provider or mental health professional for evaluation and intervention.

Tips for Medical Coders

Document the intentional induction of symptoms in another person, including the relationship between the perpetrator and victim, the nature of the symptoms, and any corroborating evidence (e.g., medical records, witness statements). Ensure documentation supports the diagnosis and distinguishes it from other conditions (e.g., malingering, somatic symptom disorder).