What is the Difference Between Factitious Disorder and Malingering

Factitious disorder and malingering are two conditions with overlapping symptoms, such as people exaggerating or making up symptoms of an illness. They are two variations on a similar theme. But the reason why people behave in this way is different in these two conditions.

The key difference between factitious disorder and malingering is their cause. Factitious disorder is a mental illness where people exaggerate or lie about having medical or psychiatric symptoms with no clear cause, while malingering is a non-psychiatric condition where people exaggerate or make up symptoms of an illness, either physical or psychiatric, for personal gains.

CONTENTS

1. Overview and Key Difference
2. What is Factitious Disorder  
3. What is Malingering
4. Similarities – Factitious Disorder and Malingering
5. Factitious Disorder vs Malingering in Tabular Form
6. Summary – Factitious Disorder vs Malingering
7. FAQ – Factitious Disorder and Malingering

What is Factitious Disorder?

Factitious disorder is a mental disorder, also known as somatic symptom disorder or a somatoform disorder. People with factitious disorders usually exaggerate or lie about having medical or psychiatric symptoms without a known cause. It is mainly of two types: factitious disorder imposed on self (FDIS), where a person lies about their own health, and factitious disorder imposed on another (FDIA), where a person lies about someone else’s health. Researchers believe this condition is caused by both biological and psychological factors. Moreover, people with this condition may lie about or mimic symptoms, hurt themselves to bring symptoms, alter diagnostic tests, and be willing to undergo painful or risky tests and operations to obtain sympathy and special attention.

Factitious disorders can be diagnosed through medical history, physical examinations, laboratory tests, imagery, and psychological testing. Furthermore, treatment options for factitious disorder include medications for anxiety and depression, psychotherapy, cognitive-behavioral therapy, and family therapy.

What is Malingering?

Malingering is a non-psychiatric condition where a person shows false medical symptoms or exaggerates existing symptoms, hoping to be rewarded in some way. Malingering does not have specific symptoms. People who show malingering suddenly start displaying physical or psychological symptoms when involved in a civil or criminal legal action, facing the possibility of military combat duty, committing insurance fraud, or seeking other forms of financial gain. They may also do it to get time off work, obtain prescriptions for controlled medications, reduce work obligations, or avoid prison time.

Malingering can be diagnosed through family information, physical examination, and mental health examination. Furthermore, people who have this condition may exhaust their excuses and give up ultimately.

Similarities Between Factitious Disorder and Malingering

1. Factitious disorder and malingering are two conditions where people exaggerate or make up symptoms of an illness.
2. Both are two variations on a similar theme.
3. They involve deception.
4. Both can be diagnosed through questionnaires and physical examination.

Difference Between Factitious Disorder and Malingering

Definition

1. Factitious disorder is a mental health disorder where people make up or exaggerate physical or psychological symptoms without any clear reason or benefit.
2. Malingering is a behavioral issue where people fake or exaggerate medical or psychological symptoms for personal gain.

Causes

1. Factitious disorder is caused by both biological and psychological factors.
2. Malingering is done for personal benefits or gains.

Symptoms

1. Factitious disorder involve exaggerating existing symptoms, making up histories, faking symptoms, causing self-harm, and tampering.
2. Malingering has no specific symptoms.

Diagnosis

1. Factitious disorder is diagnosed by medical history, physical examinations, laboratory tests, imagery, and psychological testing.
2. Malingering is diagnosed by questionnaires, family information, physical examination, and mental health examination.

Treatment

1. Factitious disorder is treated by medication for anxiety or depression, psychotherapy, cognitive behavioral therapy lifestyle, home remedies, and support groups.
2. There is no need for medication, and people who have malingering may exhaust their excuses and ultimately give up.

The following table summarizes the difference between factitious disorder and malingering.

Summary – Factitious Disorder vs Malingering

Factitious disorder and malingering are two conditions related in some way. Both these conditions involve fabrication or exaggeration of symptoms. But their primary motive is different. People with factitious disorders intentionally produce or exaggerate symptoms, but they can’t control their behavior. It is not for personal gain but due to a psychological need. However, people who malinger intentionally falsify symptoms with a clear objective in mind, such as personal or financial gain. This is the summary of the difference between factitious disorder and malingering.

FAQ: Factitious Disorder and Malingering

1. What is a factitious disorder example?

• Factitious disorder is a mental health condition where people deceive others by appearing sick, by purposely getting sick, or by self-injury. It can also happen when family members or caregivers falsely present others, such as children being ill, injured, or impaired.

2. What is Munchausen by proxy called now?

• Munchausen syndrome by proxy (MBP) is a type of factitious disorder where a person either fakes or produces symptoms in someone else, usually their child. This is now called ‘fabricated or induced illness by carers’ (FIIC).

3. What is the best treatment for factitious disorder?

• Psychotherapy, talk therapy, behavior therapy, and family therapy may help control stress and develop coping skills. Other mental health conditions like depression and anxiety should be addressed and managed by medications.

4. What is an example of malingering?

• A person changing a urine sample or raising the temperature of a thermometer with a lamp, insurance fraud, shirking obligations for military service, and drug abusers faking illness or pain to receive drugs of abuse such as opioids are some examples of malingering.

5. What are the treatment options for malingering?

• Malingering can’t be treated with medication or therapy as it is done for personal or financial gains, and it is not a mental illness.  The main methods used to deal with malingering are detection and management.

Reference:

1. “Factitious Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research.
2. Cirino, Erica. “Malingering: Definition, Symptoms, Causes, Tests, and More.” Healthline, Healthline Media.

Image Courtesy:

1. “FactitiousDisorderAnother” By Osmosis – (CC BY-SA 4.0) via Commons Wikimedia

2. “Sick Blonde Girl in Bed” (CC0) via Pexels

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