Caregivers who lie about abuse injuries in dependents solely to protect themselves from lia- bility are not diagnosed with factitious disorder imposed on another because protection from liability is an external reward (Criterion C, the deceptive behavior is evident even in the ab- sence of obvious external rewards). Such caregivers who, upon observation, analysis of med- ical records, and / or interviews with others, are found to lie more extensively than needed for immediate self—protection are diagnosed with factitious disorder imposed on another.
Somatic symptom disorder. In somatic symptom disorder, there may be excessive at- tention and treatment seeking for perceived medical concerns, but there is no evidence that the individual is providing false information or behaving deceptively.
Malingerlng. Malingering is differentiated from factitious disorder by the intentional re- porting of symptoms for personal gain (e.g., money, time off work). In contrast, the diag- nosis of factitious disorder requires the absence of obvious rewards.
Conversion disorder (functional neurological symptom disorder). Conversion disorder is characterized by neurological symptoms that are inconsistent with neurological patho- physiology. Factitious disorder with neurological symptoms is distinguished from con- version disorder by evidence of deceptive falsification of symptoms.
Borderiine personality disorder. Deliberate physical self-harm in the absence of suicidal intent can also occur in association with other mental disorders such as borderline person- ality disorder. Factitious disorder requires that the induction of injury occur in association with deception.
Medical condition or mental disorder not associated with intentional symptom falsifi- cation. Presentation of signs and symptoms of illness that do not conform to an identi- fiable medical condition or mental disorder increases the likelihood of the presence of a factitious disorder. However, the diagnosis of factitious disorder does not exclude the presence of true medical condition or mental disorder, as comorbid illness often occurs in the individual along with factitious disorder. For example, individuals who might manip- ulate blood sugar levels to produce symptoms may also have diabetes.
300.89 (F45.8)
This category applies to presentations in which symptoms characteristic of a somatic cial, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the somatic symptom and related disorders diagnos- tic class.
Examples of presentations that can be specified using the “other specified" designation include the following: 1. Brief somatic symptom disorder: Duration of symptoms is less than 6 months.
2. Brief illness anxiety disorder: Duration of symptoms is less than 6 months.
3. Illness anxiety disorder without excessive health-related behaviors: Criterion D for illness anxiety disorder is not met.
4. Pseudocyesis: A false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy.
300.82 (F45.9)
This category applies to presentations in which symptoms characteristic of a somatic cial, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the somatic symptom and related disorders diagnos- tic class. The unspecified somatic symptom and related disorder category should not be used unless there are decidedly unusual situations where there is insufficient information to make a more specific diagnosis.
, Feedinga
Eating Disorde?
Feed | rig an d eati ng disorders are characterized by a persistent disturbance of eat- ing or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning. Diagnos- tic criteria are provided for pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge-eating disorder.