title: Factitious Disorder in a Patient Claiming to be a Sexually Sadistic Serial Killer.
abstract: Factitious disorder involves the conscious simulation of psychological or physiological symptoms of illness, for the purpose of fulfilling the unconscious desire to be taken care of or to assume the "sick role." Typically patients with factitious disorder simulate conditions that are designed to arouse feelings of empathy in care providers with the intention to engage them in caretaking. However, patients might also simulate conditions that arouse revulsion or rejection and still meet full diagnostic criteria for factitious disorder. In this case report, we present a patient who fabricated an elaborate history of being a sexually sadistic serial killer with homicidal ideation with the intention of obtaining personal attention, nurturance, and empathy from his psychotherapist. However, given the nature of his feigned condition, the patient frightened the very person whom he sought to engage in caretaking.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, CSC 2200, Los Angeles, CA, 90089-9074.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Fischer
authors.affiliation: Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, 760 Westwood Plaza, Los Angeles, CA, 90095.|Department of Veterans Affairs Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073.
authors.forename: Mace
authors.initials: M
authors.lastname: Beckson
authors.affiliation: Park Dietz & Associates, Inc., 2906 Lafayette Road, Newport Beach, CA, 92663.
authors.forename: Park
authors.initials: P
authors.lastname: Dietz
mesh_terms: D003134:Commitment of Persons with Psychiatric Disorders; D005162:Factitious Disorders / Q000175:diagnosis / Q000523:psychology*; D006708:Homicide; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis; D010555:Personality Inventory; D012448:Sadism; D014728:Veterans / Q000523:psychology
keywords: factitious disorders; forensic psychiatry; forensic science; hospitalization; malingering; sadism