The symptoms are worse when the individual is aware of being observed.
Management: It is same as discussed above under “Factitious disorder with physical symptoms.”It is defined by intentional production of physical or psychological symptoms motivated by identifiable “external incentives” (avoiding work or military obligation, obtaining financial compensation, evading criminal prosecution, obtaining drugs etc.).
In contrast to factitious disorder, there should be an identifiable goal for behaviour other than that of securing the role or parenthood. A high index of suspicion of malingering should be aroused if any combination of the following is noted: (i) Medicolegal context of presentation e.g., the person’s being referred by the court to the physician for examination.(ii) Marked discrepancy between the person’s claimed distress or disability and the objective findings.(iii) Lack of cooperation with the diagnostic evaluation and prescribed treatment regimen.(iv) The presence of antisocial personality disorder.
Complaints for pain and requests for analgesics are very common.
The patients often eagerly undergo multiple invasive procedures and operations and they have multiple scars on abdomen known as Grid iron Abdomen.
Essay Contents: Factitious disorders are characterized by the conscious, deliberate, and surreptitious feigning of physical or psychological symptoms to simulate disease.
The only goal that is evident in such behaviour is the attainment of the role of the patient; this motivation is contrasted to malingering, in which a clear identifiable role is evident such as money, disability or relief from work.
The detection of malingering is difficult, and each medical speciality has tended to develop its own set of guidelines for detection.
Symptom relief in malingering is not often obtained by suggestions, hypnosis or intravenous barbiturates as it frequently is in conversion disorder.
A “pseudodementia” is differentiated from dementia that there are often near-miss, approximate answers rather than gross inability to answer questions correctly.
In a true psychosis such as schizophrenia, the individual’s symptoms will persist but in factitious disorder, they may appear when patient is under the impression that he or she is being watched.