The authors question the clinical status of factitious disorder with
psychological symptoms as a mental disorder. In particular, they argue that
unresolved issues regarding the motivational basis of this disorder and the
lack of clearly delineated inclusion, exclusion, and outcome criteria
seriously compromise its diagnostic legitimacy. Two case reports are
presented to illustrate these difficulties. Future studies should consider
these empirical and conceptual difficulties in refining the diagnosis of
factitious disorder with psychological symptoms for DSM-IV.