BMJ Best Practice Podcast Factitious disorders
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Jul 22, 2025 Join James Levenson, a Professor of Psychiatry at Virginia Commonwealth University and author on factitious disorders, as he unravels the complexities of this elusive condition. Delve into the diagnostic detective work needed to differentiate factitious disorder from genuine illnesses, including the significance of specific medical details. The discussion also touches on the moral dilemmas when children are involved and how social media can complicate situations. Levenson highlights the balance required in treating patients who present deceptive histories, intertwining empathy with skepticism.
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Factitious Disorder vs Malingering
- Malingering is faking illness for external gain, not a psychiatric diagnosis.
- Factitious disorder patients deceive for internal psychological reasons, not for material gain.
Detective Work in Diagnosis
- Diagnose factitious disorder through medical detective work rather than psychiatric interviews.
- Use lab tests, infection patterns, and unusual clinical presentations to uncover deception.
Rare Diseases and Suspicious Stories
- A patient was suspected of having rare diseases but laboratory results disproved the diagnosis.
- Suspicious stories and normal inflammation markers suggested the illness was fabricated.