What is a key consideration to avoid mislabeling when diagnosing Factitious Disorder?

• A. Rash labeling with immediate diagnosis
• B. Document carefully and consider safeguarding if abuse suspected
• C. Ignore red flags
• D. Publish in a journal

Answer: (B)

The key idea is to approach suspected Factitious Disorder with careful, objective documentation and a concern for safeguarding if abuse is suspected. Factitious Disorder centers on deliberate fabrication or induction of symptoms to assume the sick role, but arriving at that label too quickly can mislabel a patient and miss other important issues. By documenting observed inconsistencies between reported symptoms and objective findings, recording the sequence of events, and noting how investigations and responses unfold, you build a clear, evidence-based picture rather than a hasty conclusion. It’s also essential to consider differential diagnoses such as malingering (driven by external incentives) or genuine medical or psychiatric conditions like somatic symptom disorder, rather than attributing everything to deception.

If there are any signs or risk factors for abuse, neglect, or coercion, safeguarding procedures should be considered. This protects the patient, ensures safety, and can reveal underlying drivers of the presentation that might otherwise be overlooked. These steps help prevent mislabeling and support appropriate, ethical care.