Can You Offer an Example of Medical Deception?

Key Takeaways

• Motivation distinguishes malingering (external gain) from factitious disorder (psychological need to inhabit the sick role and receive attention or nurturance).
• Lack of expected therapeutic response, coupled with symptom escalation or shifting complaints, can suggest illness behavior aimed at sustaining clinical engagement.
• Discrepancies between observed function and reported disability, or between serial examinations and claimed symptoms, are common red flags.
• Patterns of doctor shopping, frequent unscheduled visits, and resistance to collateral information or record release often accompany deceptive presentations.
• Evidence of manipulation includes tampering with specimens, inducing injury or infection, inconsistent medication adherence, or unusually eager pursuit of invasive tests and procedures.