CUPIDS ARROW - AN UNUSUAL PRESENTATION OF FACTITIOUS DISORDER

A person with factitious disorder consciously creates the signs or sym ptoms of a medical or psychiatric condition for no apparent reason oth er than to assume the role of the patient. Because such patients usual ly prove difficult to engage in a therapeutic alliance, the deeper mot ives for this behavior generally remain inaccessible to both patient a nd physician. Furthermore, the diagnosis of factitious disorder is oft en one of exclusion and thus often one of lingering uncertainty with r espect to etiological factors.(1-2) The following case brings to light several of these diagnostic and management issues and illustrates the considerable morbidity and potential lethality associated with factit ious conditions.