Differential diagnosis

Factitious disorder must be distinguished from authentic medical conditions.

Factitious disorders are differentiated from somatoform disorders, where physical symptoms, although not caused by physical disease, are not intentionally produced. Patients with factitious disorder, although they may not be aware of the motives that drive them, voluntarily produce their physical or psychological symptoms. The disorders may overlap, however, and non-wandering female patients with factitious physical disorders may have more in common with those with somatoform disorders than with men with factitious disorder or with malingerers. Fink(16) found that 20 per cent of patients with persistent somatization (i.e. patients with more than six admissions to the general hospital with medically unexplained symptoms) also had a factitious illness.

A more difficult distinction is between factitious disorder and malingering. Malingerers, described below, have clear-cut goals, often personal profit, and lack a history of hazardous, unnecessary invasive procedures.

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