Factitious disorders involve patients intentionally producing or faking physical or psychological symptoms to convince others they are sick. The goal of the patient is simply to assume the “sick role,” often as a means of getting attention or sympathy. In this way, factitious disorders differ from malingering, which involves feigning illness for the purpose of material gain.

Patients with factitious disorders often complain of various physical symptoms (e.g., aches and pains) and/or mental symptoms (e.g., hallucinations). They may manipulate physical signs (e.g., by adding a foreign substance to a urine specimen) and even deliberately injure themselves.

Because these fictional symptoms are by nature hard to detect objectively, factitious disorders can be difficult to diagnose. This is especially true in patients who have a sophisticated knowledge of diseases and medical terminology. Some patients are so deeply affected by a factitious disorder that they may be willing to undergo potentially painful and dangerous procedures. Other patients may be hospitalized repeatedly for short stays or travel from place to place seeking care.

At first, it may not be obvious to a physician that a patient is faking symptoms. During an initial visit, a physician is likely to perform a physical examination, compile a thorough medical history and conduct various tests to try to identify the source of the patient’s complaints. However, over time, it may become more obvious that the patient is faking the illness. Patient history of multiple procedures and hospitalizations may offer one clue. Eventually, a factitious disorder may be diagnosed.

Factitious disorders are often chronic, lifelong conditions that can be difficult to treat. Most patients deny that their problem is psychological and discontinue treatment when such a diagnosis is made. Treatment may vary depending on the type of factitious disorder that is diagnosed. In most cases, the chief form of treatment is psychotherapy.