Course and prognosis

Factitious disorder may be limited to one or more brief episodes, but is usually chronic. For example, of 10 patients identified in a general hospital setting and followed up, at least one was known to have died as a result of factitious behaviour 4 months after the index admission.(6) Only one of the remaining nine patients accepted psychiatric treatment after discharge from hospital. Other authors have, however, reported a less gloomy outcome.(5) Outcome may be determined by how patients are managed, once their deceptions become manifest. Regrettably, the unmasking of the disorder is often the end of the story. Psychological support following hospital discharge may be associated with improved outcome.(5) Non-wanderers with more stable social networks may have a better prognosis than wanderers.(3) Engaging a patient with factitious disorder in long-term psychological treatment occurs so rarely that it often becomes the subject of a case report.

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