Factitious disorder and malingering

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Target exams

Red flags

• Life-threatening self-induced injury (sepsis from injection, severe hypoglycaemia, bleeding, overdose) — treat medically first; do not delay for psychiatric labelling
• Child or vulnerable adult with unexplained recurrent illness and carer-linked pattern — emergency safeguarding pathway; do not rely on psychiatry alone
• Staff collusion, false certification, or continuation of high-risk procedures solely to maintain alliance when deception is highly probable
• Solo confrontational accusation without multidisciplinary plan — risk of flight, escalation, or litigation
• Assuming all inconsistency is factitious and missing undiagnosed organic disease
• Punitive discharge without safety net when self-harm or iatrogenic dependency is active