Factitious disorders

A factitious disorder or FD is an illness whose symptoms are either self-induced or falsified by the patient. The motives of the patient can vary: for a patient with Munchausen syndrome their primary aim is to obtain sympathy, nurturance and attention, while in the case of malingering the patient wishes to obtain external gains such as drugs or disability payments or to avoid an unpleasant situation, such as military duty. Strictly speaking, FD and malingering cannot be diagnosed in the same patient, yet clinicians find that patient's motives for the ruses can vary over time and, as a result, both diagnoses may apply. FD and Munchausen syndrome are considered mental disorders; malingering, though sometimes a focus of clinical attention, is not.

Factitious disorders should be distinguished from conversion disorder, in which the patient is unaware that the symptoms being experienced are not medically caused. In hypochondriasis, the patient honestly believes he or she has a particular medical disorder and, like the FD patient, may seek contact from multiple physicians, emergency departments, and hospitals. Somatization disorder involves a patient's believing he or she has symptoms in multiple organ systems, with corresponding authentic concern. The somatoform disorders, of which conversion disorder, hypochondriasis, and somatization disorder are a part, result in authentic concern in the patient, while FD patients know that they have feigned or produced the medical or psychological symptoms with which they present.