Factitious disorder and malingering are often linked, because both involve the feigning or production of physical and/or psychological symptoms absent any underlying pathology. The distinction between the two is the motivation for the production of symptoms. In factitious disorder, the motivation is presumed to be unconscious and is related to the desire to assume the sick role. In contrast, malingering is viewed as the intentional production (or reporting) of symptoms for a specific purpose associated with some secondary gain, such as evading criminal prosecution or receiving financial compensation. Thus, in distinguishing the two, the treater is left to determine the underlying motivation for symptom production. Although there has been argument about the veracity of this taxonomy (Cunnien 1997; Rogers et al. 2005), reliable discrimination is important for a variety of reasons. Of primary importance is that the two conditions call for very different treatment or management approaches. The following discussion of both disorders will aid the clinician in making this crucial determination.