Source: Reference 1 Table 2 Characteristics of amnesia in factitious disorder
and malingering Factitious amnesia * Intentional feigning of signs and symptoms * Association with Cluster B personality disorders * Medical or psychiatric illness * Diagnosed on axis I * Motivated to assume sick role--unconscious drive * Referral to health professional * Clinician's outlook * "Suffering" Malingered amnesia * Intentional feigning of signs and symptoms * Possible antisocial personality disorder * Meeting personal needs * An ICD-9 V code; not a disorder * Motivated by external incentives--conscious drive * May involve legal system * Clinician's outlook * "Liar" Source: Reference 6 Table 3 DSM-5 criteria for conversion disorder (functional neurological symptom disorder) A.
, also known as Munchausen syndrome, is an extreme condition that defines patients who intentionally produce or feign symptoms or disabilities, either physical or psychological.
This category includes: * somatic symptom disorder * illness anxiety disorder * conversion disorder (functional neurological symptom disorder) * psychological factors affecting other medical conditions * factitious disorder
* other specified somatic symptom and related disorder * unspecified somatic symptom and related disorder.
Key Words: cardiopathia fantastica, factitious disorder
, Munchausen syndrome, somatoform disorders
by proxy: Clinical features, detection, and management, in Feldman MD, Eisendrath SJ (eds): The Spectrum of Factitious Disorders
Informed skepticism is acceptable--even encouraged--in making a diagnosis of malingering, factitious disorder
, some personality disorders, substance abuse, and psychotic states, to name a few.
A is beyond usual age of onset, and symptoms have lasted <1 month Broca's aphasia/CVA No corresponding organic lesions on MRI Factitious disorder
No motivation to assume the sick role Psychotic speech No other evidence of psychosis CVA: cerebrovascular accident; EEG: electroencephalography; MRI: magnetic resonance imaging
Reverend R meets the DSM-IV-TR criteria for factitious disorder
B's intentional production of physical symptoms strongly suggested malingering, but we instead diagnosed factitious disorder
because he was clearly motivated to play the sick role despite lack of a secondary gain (Box 2).
19) Symptom validity testing can help distinguish factitious disorder
and malingering (see "Neurocognitive impairment: Feigned, exaggerated, or real?
We also must watch for signs of a delusional or factitious disorder
or malingering--any of which would suggest the allegations are false.
Malingerers and patients with factitious disorder
typically will insist on their desire to be cured and discharged.