Factitious Disorders

Abstract

Factitious disorder (FD) is a psychiatric disorder in which patients deliberately perpetrate or lie about medical and/or psychiatric illness in themselves or others. Although it has been thought to be driven by the need to take the patient role, no body of research has clearly identified the underlying motivation, cause, or treatment for it. Illness deception, along with the similarity to other diagnostic categories, such as somatic symptom disorder, personality disorder, and malingering (which is not considered a mental illness but can be a focus of clinical attention), has hindered basic and clinical research into the nature and treatment of FD. Still, moving psychiatric treatment of FD forward can take advantage of tools already available to clinicians, including motivational interviewing techniques to facilitate empathic confrontation in the general hospital. Despite the lack of treatment studies, employing therapies known to be effective for borderline personality disorder, which is similar in many ways to FD, for FD patients willing to participate might be helpful. This review contains 4 figures, 6 tables and 27 references Key words: factitious disorder imposed on another, factitious disorder imposed on self, malingering, medically unexplained symptoms, Munchausen by proxy, Munchausen syndrome, pseudologia fantastica, somatic symptom disorders