Differentials
Malingering
SIGNS / SYMPTOMS
External incentives are present, such as desired medications (stimulants, opiates), disability payments, and leaving incarceration for a more desirable setting.
In factitious disorder, patients are motivated by a primary desire to assume the sick role rather than by the hope to achieve external rewards.
INVESTIGATIONS
No differentiating tests. Diagnosis based on history.
Somatic symptom and related disorders
SIGNS / SYMPTOMS
Symptoms are produced unconsciously in somatic symptom disorder and functional neurological symptom disorder, whereas in factitious disorder the signs or symptoms of illness are intentionally feigned. It may be difficult to differentiate, given that the patient is unlikely to initially disclose his or her motivation.
INVESTIGATIONS
No differentiating tests. Diagnosis based on history.
Organic disease
SIGNS / SYMPTOMS
When diagnostic testing does not determine a cause for signs or symptoms, the patient may have an actual rare or difficult-to-diagnose illness. It may be difficult to differentiate, given that the patient with factitious disorder is unlikely to initially disclose his or her motivation.
INVESTIGATIONS
No differentiating tests. Diagnosis based on history.
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