Having a person come into a clinician’s office and presenting with symptoms of one or more disorders can be a tricky process for the clinician to try to diagnose, even without the presence of factitious symptoms. The presence of factitious symptoms can make the diagnosis very complicated because the clinician would need to have the patient go through their history, which would be a normal step, but then if the clinician suspects any kind of factitious disorder, generally a more thorough history would be required. Because the person feels a need to continue to be sick they would be complaining of the same symptoms over and over again, or possibly complaining of the symptoms getting worse. The problem would be that there isn’t anything real to back it up. A misdiagnosis would come into play, probably several times. It could be possible that factitious disorders are responsible for the averages given when it comes to the length of time it takes to diagnose.
People who suffer from factitious disorder don’t have an ulterior motive, people who malinger do. Malingering is when someone gives factitious symptoms in order to gain something. Malingering generally causes a person to choose not to follow a Doctor’s reference for psychiatric care. In rare cases when someone who is malingering does choose to seek psychiatric help, the sessions don’t offer any kind of help to further the person’s treatment. There are various things that motivate a person to malinger. These could include trying to gain material items such as a car or jewelry or to win a lawsuit for monetary value. It could also be something as simple as to gain someone’s attention.
Between having patients come in with factitious symptoms either controlled or uncontrolled and people who are malingering, it is easy to see how a clinician would need to be extremely cautious when it comes to giving a diagnosis.
References: Malingering. Psychnet-uk.com.; The Unexplained. Bellevue.edu