The diagnostic criteria for Factitious Disorders now appear and are classified under Somatic Symptom and other Related Disorders in DSM-5
Factitious Disorder Imposed on Self: Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. The individual presents himself or herself to others as ill, impaired, or injured. The deceptive behavior is evident even in the absence of obvious external rewards. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder. Specifiers include: Single episode and Recurrent episodes (DSM-5).
Factitious disorders are consciously determined surreptitious simulations or productions of diseases. Factitious disorder imposed on self is relatively uncommon, but when present it consumes large amounts of professional time and medical costs. The Factitious disorder imposed on another is a particularly malignant form of child abuse that physicians must identify and manage in order to save the health or lives of children.
(DSM-5 does not list the following four diagnostic subtypes of factitious disorder however as they are subsumed under the general Factitious Disorder heading It is important to discuss the differing classes of patients who present with Factitious disorder.
1. Some patients with factitious disorder present with predominantly psychological signs & symptoms
Patients with factitious disorders may simulate psychological conditions and psychiatric disorders. For example, a patient may feign bereavement by reporting that someone to whom he or she was close has died or been killed in an accident. Patients may simulate symptoms of posttraumatic stress disorder or provide false reports of previous trauma (e.g., a civilian accident or combat experience). Closely related to factitious posttraumatic stress disorder is the false victimization syndrome, in which the patient falsely claims some type of abuse. For example, a woman may falsely report that she had been raped. Other simulated psychological disorders include various forms of dementia, amnesia, or fugue; multiple personality disorder; and, more rarely, schizophrenia.
2. Patients sometime present with predominantly physical signs & symptoms
The production of physical symptoms or disease is probably the most common form of factitious disorder. Essentially all medical diseases and symptoms have been either simulated or artificially produced at one time or another. Among the most common of these disorders are factitious hypoglycemia, factitious anemia, factitious gastrointestinal bleeding, pseudoseizures, simulation of brain tumors, simulation of renal colic, and more recently, simulation of acquired immunodeficiency syndrome (AIDS).There are a group of patients with Factitious Disorder who present with Combined Psychological & Physical Signs & Symptoms.
A patient may be admitted to the hospital with factitious physical symptoms and, in the course of hospitalization, perhaps in an attempt to obtain more sympathy or interest, may report or simulate a variety of psychological symptoms such as having experienced ...