Update on Factitious Disorders

Abstract

Objective: Since factitious disorders entered the official psychiatric nomenclature in DSM-III and DSM-III-R, there has been a proliferation of reports and commentary about this unusual disorder. We present an update of the recent literature. Method: The psychiatric and medical literature was searched. Clinical reports and critical/theoretical papers were reviewed; eighty-five are summarized here. Results: Available data is descriptive and anecdotal. Reports focus on the following four topics, which are discussed here: 1) diagnostic issues, 2) the newly proposed DSM-IV category of factitious disorder by proxy, 3) epidemiology and course, 4) new developments in treatment and management. Conclusions: Factitious disorders are uncommon but serious illnesses that present diagnostic and management dilemmas. Deriving systematic information about these illnesses is a major challenge.