Of 20 patients who falsely reported the deaths of loved ones in order to
assume the patient role, most presented with depression and suicidal
ideation secondary to reported multiple dramatic deaths for which there was
no available verification, and many had histories of factitious physical
symptoms, manipulative suicide attempts, substance abuse, and sociopathy.
Diagnostic categories were of limited usefulness for these patients.
Factitious symptoms can better be understood as one form of dysfunctional
care-eliciting behavior. The authors recommend early and repeated
confrontations in a firm but nonjudgmental manner combined with referral to
outpatient psychotherapy focused on the underlying characterological