Which disorder involves presenting as ill to oneself despite no actual illness?

• A. Factitious disorder
• B. Malingering
• C. Somatic symptom disorder
• D. Conversion disorder

Answer: (A)

Deliberate feigning or production of illness to assume the sick role is the hallmark of factitious disorder. In this condition, the person intentionally creates or exaggerates physical or psychological symptoms not for external gain, but to receive care, attention, and the sick role itself. The drive is internal and the behavior is deceptive, even if the symptoms may sometimes seem plausible or be medically plausible.

This differs from other patterns. Malingering involves intentional symptoms for external rewards—like money, disability benefits, or avoiding work—so the motivation is external rather than psychological need for care. Somatic symptom disorder features genuine distress and persistent worry about somatic symptoms, but the symptoms aren’t intentionally produced or feigned. Conversion disorder (functional neurological symptom disorder) presents neurological-like symptoms that aren’t explained by medical disease and aren’t consciously produced; the symptoms typically arise in response to stress rather than from a conscious attempt to deceive.

So, presenting as ill without an actual illness, driven by a need to be cared for, fits factitious disorder best.