Psych Vivas · General adult psychiatry — factitious disorder and malingering
Factitious disorder and malingering — structured clinical viva
Fellowship viva covering FDIS vs malingering vs FND, Bass/Halligan principles, Mittenberg base rates, Slick/Rogers detection frameworks, Eastwood management limits, and legal role clarity.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the psychiatry registrar on C-L. A 41-year-old is admitted with non-epileptic events and claimed complete memory loss after a minor workplace incident with an open compensation claim. Ward staff observe normal conversation and smartphone use when unobserved. The medical team wants you to 'get them sectioned as Munchausen'. Defend nosology, differential including FND, assessment with collateral and validity testing, ethics of documentation and non-collusion, and a management plan.
Interpretation
Reveal interpretationShowHide
This stem mixes possible malingering (compensation claim, discrepancy under observation) with possible FND (non-epileptic events) and residual factitious considerations. Examiners reward candidates who refuse the false dichotomy "section as Munchausen" and instead structure intentionality, base rates, collateral, role clarity, and non-collusive care.[1][2][3]
References7ShowHide
- [1]Bass C, Halligan P Factitious disorders and malingering: challenges for clinical assessment and management Lancet, 2014.PMID 24612861
- [2]Bass C, Halligan P Factitious disorders and malingering in relation to functional neurologic disorders Handb Clin Neurol, 2016.PMID 27719868
- [3]Mittenberg W, Patton C, Canyock EM, Condit DC Base rates of malingering and symptom exaggeration J Clin Exp Neuropsychol, 2002.PMID 12650234
- [4]Slick DJ, Sherman EM, Iverson GL Diagnostic criteria for malingered neurocognitive dysfunction: proposed standards for clinical practice and research Clin Neuropsychol, 1999.PMID 10806468
- [5]Rogers R, Kropp PR, Bagby RM, Dickens SE Faking specific disorders: a study of the Structured Interview of Reported Symptoms (SIRS) J Clin Psychol, 1992.PMID 1401150
- [6]Eastwood S, Bisson JI Management of factitious disorders: a systematic review Psychother Psychosom, 2008.PMID 18418027
- [7]Rogers R, Bender SD, Hartigan SE An overview of malingering and deception in neuropsychiatric cases Behav Sci Law, 2024.PMID 38047870