How is factitious disorder imposed on another diagnosed?

Diagnosing FDIA is very difficult because of the dishonesty that is involved. Doctors must rule out any possible physical illness as the cause of the child's symptoms, and often use a variety of diagnostic tests and procedures before considering a diagnosis of FDIA.

If a physical cause of the symptoms is not found, a thorough review of the child's medical history, as well as a review of the family history and the mother's medical history (many have factitious disorder imposed on self) might provide clues to suggest FDIA. Often, the individual with FDIA may have other comorbid psychiatric disorders. Remember, it is the adult, not the child, who is diagnosed with FDIA. Indeed, the most important or helpful part of the workup is likely to be the review of all old records that can be obtained. Too often, this time-consuming but critical task is forgotten and the diagnosis is missed. Physicians will ask Children’s Services, and the Legal Department for assistance in reviewing the facts.

Last reviewed by a Cleveland Clinic medical professional on 11/26/2014.


  • American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders 5th ed. Arlington, VA American Psychiatric Publishing .pp 324-326.
  • Stirling J. Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in a Medical Setting, Pediatrics. 2007;119:1026-1030. Accessed 01/06/2015.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy