Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

The Factitious Patient

While the malingering patient does want financial remuneration, they do not seek out painful and/or dangerous procedures, and they do not decline a workers’ compensation settlement. For the malingering patient, settlement is the goal.

However, factitious disorder can present with psychological symptoms, physical symptoms or both.

The patient may be willing to run severe risk just to maintain himself/herself in a patient role. For complex reasons, partially but not fully explained by dependency, she finds herself most comfortable when in a role of chronic disability. She likes the attention, the affection, the concern and the lack of more appropriate responsibility.

It needs to be determined whether this is truly factitious disorder, and, if so, to insure that those treating her are aware that this is her goal. Only in this way can you assure her safety. Patients with factitious disorder will put themselves in harms way rather than relinquishing the patient role.”

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