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Sick, or faking it?

Current Psychiatry. 2019 September;18(9):49-52
September 1, 2019|Psychiatry
Ralph de Similien, MD;Boris L. Lee, MD;Danielle R. Hairston, MD;Snezana Sonje, MD
Author and Disclosure Information

Dr. de Similien is a community psychiatrist at Aspire Health Alliance, Boston, Massachusetts. Dr. Lee is a PGY-5 Psychiatry Resident and Chief Fellow, Child and Adolescent Psychiatry Fellowship, Department of Psychiatry and Human Behavior, UC Irvine Medical Center, Orange, California. Dr. Hairston is Assistant Professor, Department of Psychiatry, Howard University Hospital, Washington, District of Columbia. Dr. Sonje is Assistant Professor, Department of Psychiatry, and Director, Consultation Liaison Service, Howard University Hospital, Washington, District of Columbia.

Disclosures
The authors report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.

Mr. W, age 53, presents to the ED with severe chest pain. The ED physician recognizes Mr. W from previous visits, suspects he is feigning symptoms, and orders a psych consult. How do you proceed?

Bottom Line

A patient with factitious disorder stimulates, induces, or aggravates illnesses to gain the status of being a patient. Treatment options include psychiatric care, psychoeducation, or psychotherapy. However, due to poor insight, a patient with factitious disorder is unlikely to enter psychiatric treatment on his/her own.

Related Resources

  • Yates GP, Feldman MD. Factitious disorder: a systematic review of 455 cases in the professional literature. Gen Hosp Psychiatry. 2016;41:20-28.
  • Galli S, Tatu L, Bogousslavsky J, et al. Conversion, factitious disorder and malingering: a distinct pattern or a continuum? Front Neurol Neurosci. 2018;42:72-80.

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