Factitious Disorder Workup

  • Author: Todd S Elwyn, MD; Chief Editor: Eduardo Dunayevich, MD   more...
 
Updated: Aug 23, 2011
 

Laboratory Studies

  • The diagnosis of factitious disorder is typically made late, after other diagnostic possibilities have been exhausted. Laboratory studies can be especially helpful in facilitating the diagnosis of many physical illnesses as factitious.
    • For example, patients with hypoglycemia can be assessed for exogenous insulin injection by a finding of increased serum insulin/C-peptide ratio (>1.0) during a hypoglycemic episode.[8]
    • Patients who complain of kidney stones can be asked to filter their urine for stones, and the submitted material can be tested for composition.
    • A tissue biopsy can be helpful in revealing the factitious nature of lesions in which foreign material has been injected to simulate naturally occurring disease.
  • Because the range of factitious illnesses is limited only by the imagination of the perpetrator, listing all possible laboratory tests that might prove useful is impossible. However, suspicion that an illness is factitious should be conveyed to the pathologist, who may be helpful in identifying ways to confirm the diagnosis.[9]
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Contributor Information and Disclosures
Author

Todd S Elwyn, MD  Staff Psychiatrist, Tripler Army Medical Center, Schofield Barracks Soldier Assistance Center

Todd S Elwyn, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Psychiatry and the Law, American College of Legal Medicine, and American Psychiatric Association

Disclosure: Nothing to disclose.

Coauthor(s)

Iqbal Ahmed, MBBS, FRCPsych (UK)  Faculty, Department of Psychiatry, Tripler Army Medical Center; Clinical Professor of Psychiatry, Clinical Professor of Geriatric Medicine, University of Hawaii, John A Burns School of Medicine

Iqbal Ahmed, MBBS, FRCPsych (UK) is a member of the following medical societies: Academy of Psychosomatic Medicine, American Association for Geriatric Psychiatry, American Neuropsychiatric Association, American Psychiatric Association, American Society of Clinical Psychopharmacology, and Royal College of Psychiatrists

Disclosure: Nothing to disclose.

Specialty Editor Board

Sarah C Aronson, MD  Associate Professor, Departments of Psychiatry and Medicine, Case Western Reserve School of Medicine/University Hospitals of Cleveland

Sarah C Aronson, MD is a member of the following medical societies: American Academy of Family Physicians, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Harold H Harsch, MD  Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin

Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: lilly Honoraria Speaking and teaching; Forest Labs None None; Pfizer Grant/research funds Speaking and teaching; Northstar None None; Novartis Grant/research funds research; Pfizer Honoraria Speaking and teaching; Sunovion Speaking and teaching; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research; Merck Honoraria Speaking and teaching

Chief Editor

Eduardo Dunayevich, MD  Adjunct Assistant Professor, Department of Psychiatry, University of Cincinnati; Clinical Research Physician, Neuroscience, Lilly Research Laboratories

Eduardo Dunayevich, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: Nothing to disclose.

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