Differential diagnosis of malingering and factitious disorder with physical symptoms

Abstract

The present article attempts to clarify the difficult diagnostic discrimination between malingering and factitious disorder with physical symptoms. It is proposed that diagnostic evaluations focusing on the patient's observed symptomatology will be limited in their accuracy and utility. Instead, a longitudinal approach is needed to include the course of the disorder over time, its response to treatment, and the proposed etiology of the disorder. It is hoped that with a better understanding of these two disorders, prompt and accurate diagnosis can lay the foundation for effective management of both malingering and factitious disorders.

Factitious Disorder by Proxy and the Abuse of a Child with Autism

“…It may be that future revisions will be necessary and, if this is the case, it is likely to be due to the fact that the motivations of disordered clients are often not knowable (Rogers et al, 1989), leading to poor reliability because compulsion is not always obvious and malingering cannot always be ruled out. Despite these reservations and the fact that the majority of the published evidence revolves around single-subject case studies and retrospective reviews (eg Overholser, 1990), there have been sufficient cases of such service users who have been 'caught' and who are genuinely unable to explain their motivations, that the syndrome must exist (Hoffman, 1990).…”

Recognizing malingering hypertension in young adults

“…This system may be used in young adults as well as other age groups. These criteria were predetermined by our team according to our extensive experience and review of the literature [3,9,14,15].…”

Factitious disorders by proxy: A trap for the unwary

“…Overholser, 1990), there are sufficient cases of service users 'caught in the act' who are genuinely unable to explain their motivations that the syndrome must exist (Hoffman, 1990). In addition, where psychological symptoms are feigned, it is sometimes impossible to detect the falsification and so support the diagnosis of factitious disorder (e.g.…”