Factitious disorder: clinical manifestations and warning findings – a systematic review
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Introduction: Factitious Disorder (FD) is defined by the intentional fabrication or exaggeration of symptoms by the patient without obvious external motivational incentives, often accompanied by clearly identifiable fraud. Current diagnostic criteria for FD have low sensitivity. Objective: To identify key warning findings associated with FD to assist in accurate diagnosis. Methods: A systematic review was conducted in adherence to PRISMA guidelines. Searches were performed across six indexing databases using a combination of terms, including "factitious disorder," "clinical presentation," "signs and symptoms," "warning signs," and "differential diagnosis." Title screening and data extraction were carried out by independent pairs of reviewers who analyzed the full texts of eligible articles. Studies published within the last 25 years describing warning findings of FD were included. Results: The review identified 423 titles, of which 56 articles were selected for full-text reading, ultimately including 45 articles. A total of 528 warning findings were noted across 31 medical specialties and 16 affected systems. The clinical manifestations were divided into two categories: subjective and objective findings. Psychiatry was the medical specialty most frequently mentioned, while the integumentary system was the most affected. Frequently cited warning findings included: a history of multiple hospitalizations, medical procedures, and consultations; inconsistent or atypical clinical histories; unexplained symptoms; unusual medical knowledge; relationships with healthcare professionals; and normal test results despite reported symptoms. Conclusion: FD presents with diverse manifestations, necessitating heightened awareness and specialized training for health professionals to ensure early diagnosis, effective management, and the avoidance of unnecessary or potentially harmful interventions.
Source: Revista Médica de Minas Gerais
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204099345