Factitious disorder is diagnosed when a patient falsely reports and/or portrays physical or mental signs or symptoms for the purpose of occupying a “sick role.” Also, the patient must not have other motives, such as those associated with malingering (e.g., financial gain or work avoidance).

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 complete physical examination and to compile a thorough medical history. Various tests may be conducted 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. Continual complaints of new symptoms and constant requests for analgesics (medications that eliminate pain) may offer other clues.

Factitious disorders may be diagnosed when it is clear that the patient is intentionally faking psychological or physical symptoms with the sole motivation of assuming the sick role.

When confronted, patients usually become hostile and deny that they are making up their symptoms. If hospitalized, the patient may suddenly leave against medical advice. It is common for patients to move on to various physicians and hospitals to continue the ruse. In some cases, patients may seek medical care in another city, state or even another country.