Factitious disorder vs. malingering can be difficult to differentiate as they have several overlapping symptoms, but their impact on overall health is important, and the main difference between them is the motivation for the symptoms. Spotting the signs is essential as a difference between factitious disorder and malingering is that people who have factitious disorder intentionally create or exaggerate symptoms without any clear motive, but someone with malingering exaggerates symptoms for a secondary, internal gain like financial compensation or avoiding criminal prosecution.
Defining Factitious Disorder and Malingering
Factitious disorder and malingering are both conditions where an individual is intentionally deceiving others, and they are fully aware of that deceit. With malingering vs. factitious disorder, someone who has malingering is intentionally fabricating medical symptoms for some type of personal gain, whereas factitious disorder is intentionally fabricating or exaggerating symptoms without any legitimate intention for benefit from that exaggeration or fabrication.
Key Differences Between Factitious Disorder and Malingering
When looking at malingering disorder vs. factitious disorder, there are some key differences.
Motivation Behind the Behavior
The motivation behind the behavior for factitious disorder vs. malingering is the primary difference. As mentioned, someone with malingering is motivated by an intentional and personal gain whereas someone with factitious doesn’t have any clear motive although they might be trying to get sympathy or attention.
Awareness of Deception
There is no key difference between factitious disorder and malingering when it comes to the awareness of deception. In both conditions individuals are aware of their deceptions.
Duration and Presentation of Symptoms
When comparing malingering vs. factitious disorder, another difference is the duration and presentation of symptoms. Factitious disorder generally presents between the ages of 15 and 20 and is up to three times more common in men than it is in women.
Common Signs of Factitious Disorder
So, what are the common signs of factitious disorder vs. malingering?
Consistent Pattern of Seeking Medical Care
The most common signs of factitious disorder are consistent patterns of seeking medical attention with inconsistent or extreme and unrelated symptoms. The symptoms are usually uncontrollable and very vague, and the symptoms will change once treatment begins.
That same individual will frequently go to the emergency room or hospital with conditions that get worse for no reason or unexpectedly relapse.
Knowledge of Medical Terminology and Symptoms
Individuals who have signs of factitious disorder will possess extensive knowledge of medical diseases, terms, and memorized textbook descriptions.
Willingness to Undergo Invasive Procedures
Those same individuals will also have a willingness to undergo very invasive medical procedures, including things that are risky or painful, operations, and more.
Manipulation of Test Results or Symptoms
Someone who has a factitious disorder might manipulate their symptoms or test results in order to continually receive attention. This can be something as severe as doctoring a test in a hospital, intentionally causing pain or problems in order to increase the likelihood of a diagnosis, and self-harm.
Common Signs of Malingering
There are some similarities when looking at the common signs of malingering.
Discrepancy Between Reported Symptoms and Objective Findings
Some of the most common signs of malingering are discrepancies between what an individual reports or claims to have and what the findings present.
External Incentive for the Behavior
As mentioned, the external incentive for the behavior is a common sign and a common difference between these two conditions.
Resistance to Treatment
Someone with malingering is more resistant to treatment. they will typically not follow up with any care they are given, or they won’t adhere to the treatments they receive. They might even be hostile or strongly opposed to accepting treatment at all, as treatment would not only reveal the factitious nature of their claims but would inhibit their ability to get a reward through the attention they receive for the condition itself.
Improvement Once Goals Are Achieved
The underlying difference between factitious disorder and malingering is internal motivation. Someone with malingering is motivated by some sense of external reward, like avoiding criminal prosecution or getting money from someone. Once those goals are achieved, symptoms tend to magically improve.
How Healthcare Professionals Can Spot the Signs
It is imperative that healthcare professionals learn to spot the difference between factitious disorder and malingering.
Comprehensive Patient History and Record-Keeping
The first way to do this is to keep comprehensive patient histories. The more records that are kept, the easier it will be to find patterns of things like unrelated symptoms or unexplained relapses, symptoms that come back long after treatment has purportedly cured them, or an unnecessarily high number of visits to a hospital.
Collaboration Across Multiple Disciplines
Keeping these histories can help other Healthcare professionals spot the signs as well particularly when there is collaboration across multiple disciplines. This type of collaboration is essential as individuals with both conditions are likely to exaggerate symptoms with inconsistency in their statements and collaboration can reveal those inconsistencies.
Use of Psychological and Diagnostic Tests
Healthcare professionals can learn to spot the signs of factitious disorder vs. malingering by using psychological and diagnostic tests. Not only can psychological tests help differentiate, but diagnostic tests can reveal any differences between the reported symptoms and objective findings.
A key difference between the two is that someone with a factitious disorder will go out of their way to compromise or alter their test results in order to corroborate the symptoms they claim, but someone who has malingering won’t necessarily do this.
Approach with Caution and Compassion
Finally, always approach with compassion and caution. Someone with malingering might have exaggerated delusions and need treatment for other conditions as well.
Conclusion
Overall, there are some key differences between factitious disorder and malingering, particularly the lengths to which an individual will go to keep their story going and the ways in which they fabricate or exaggerate medical symptoms. It is important to understand the motivations behind the behavior to ensure accurate diagnosis and appropriate care.