Psych CASC / OSCE · General adult psychiatry — factitious disorder and malingering
Explain suspected factitious behaviour and a non-collusive plan — CASC communication station
MRCPsych/FRANZCP-style communication station: maintain alliance without collusion, explain concerns factually, outline coordinated care, offer psychiatric support, address capacity/self-discharge, and safety-net mood risk.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar on the medical ward.[1]
Candidate instructions. Engage respectfully; do not collude with a false diabetes narrative; explain the team’s safety concerns using facts; outline a coordinated plan that still offers care; assess mood and self-discharge risks; avoid humiliation; check understanding and safety-net.[1][2][4]
References4ShowHide
- [1]Bass C, Halligan P Factitious disorders and malingering: challenges for clinical assessment and management Lancet, 2014.PMID 24612861
- [2]Eastwood S, Bisson JI Management of factitious disorders: a systematic review Psychother Psychosom, 2008.PMID 18418027
- [3]Krahn LE, Li H, O'Connor MK Patients who strive to be ill: factitious disorder with physical symptoms Am J Psychiatry, 2003.PMID 12777276
- [4]Margolis M, Wong TL, Shmuts R, Taylor JB Consultation-Liaison Case Conference: A Case of Factitious Disorder Imposed on Self J Acad Consult Liaison Psychiatry, 2023.PMID 37499871