Factitious Disorders with Predominantly Psychological Signs and Symptoms: A Conundrum for Forensic Experts

Abstract

We conducted the first systematic comparison of patients with Factitious Disorders with Predominantly Psychological Symptoms (FDPS), suspected malingerers, and psychiatric inpatients; all the subjects were recruited from a forensic clinic. Through the employment of the Structured Interview of Reported Symptoms (SIRS), we failed to find consistent differences on SIRS scales between nine FDPS patients and 25 suspected malingerers. However, investigation of individual SIRS items was moderately successful in distinguishing groups. Because of these relatively modest results and the absence of other validation, we questioned the diagnostic validity of FDPS and recommended its placement as provisional diagnosis. We also discuss the implications of FDPS for forensic experts consulting to the courts.