If there is definite evidence for pretending, which diagnosis should be considered instead?

• A. Somatic Symptom Disorder
• B. Factitious Disorder or Malingering
• C. Illness Anxiety Disorder
• D. Conversion Disorder

Answer: (B)

Definite deception about symptoms points to a problem where someone is intentionally feigning or producing illness for a motive. The best-match concept here is Factitious Disorder or Malingering, because both involve deliberate falsification or exaggeration of symptoms. The key difference is motivation: factitious disorder is driven by an internal need to assume the sick role, while malingering is driven by external incentives such as financial gain, avoiding work, or obtaining drugs.

This is why other options don’t fit: Somatic Symptom Disorder and Illness Anxiety Disorder center on real symptoms or preoccupation without intentional deception; the distress or worry is not based on purposely feigning illness. Conversion Disorder involves neurological symptoms that are not intentionally produced or feigned; the symptoms are not under voluntary control.