Evaluation of the Prevalence of Factitious Disorder and Its Demographic and Clinical Characteristics in Psychiatric Inpatients in Iran; A Cross-Sectional Study.

Background: Diagnosing factitious disorder (FD) poses significant medical challenges; delays impact patient care and costs. Cultural factors of each country also affect illness and behavior disorders. This study examines the prevalence, demographics, and clinical features of factitious disorder patients in Iranian psychiatric hospitals.

Methods: This cross-sectional study reviewed patient data from three psychiatric hospitals in Tehran from 2017 to 2022, confirming FD diagnoses by psychiatry faculty. Inclusion criteria were the diagnosis of FD according to ICD-10 in the last five years. We recorded demographic data, main stressors, symptoms and diagnoses and analyzed them with SPSS-25. Data are presented as numbers and percentages and compared between groups by chi-square test.

Results: A total of 17 cases with the diagnosis of factitious disorder were investigated in 5 years (4.315 per 10,000 patients). The highest frequency age range was between 20-30 years, and most of them were male. Our results showed that in only 7 cases, there was initial suspicion of factitious disorder or factitious disorder imposed on another (factitious disorder by proxy). Most of the patients had psychiatric comorbidities, among which the most common comorbidity was substance use disorder and cluster B personality disorder. Among the evidence of suspicion for the diagnosis of factitious disorder in 65% of cases was a history of multiple previous hospitalization and more than 40% of the cases were based on the pattern of repeated symptoms.

Conclusion: This study showed that FD is underdiagnosed, and more attention is needed to the signs of this diagnosis in the assessments. Also, the clinical features showed that treatment should account for comorbid disorders.