A surprise result from a super-sized database. 

Factitious disorder occurs when people intentionally produce or fake symptoms without clear external incentives, like financial gain or avoiding legal trouble. The goal is to adopt the “sick role” to gain attention or sympathy. It’s a tricky condition to diagnose since patients’ symptoms mimic real medical conditions. Take a nonjudgmental approach, practice supportive confrontation, and coordinate with your multidisciplinary team to ensure the patient receives appropriate care, though treatment adherence and outcomes are often poor.

This review covers six medical conditions—acute intermittent porphyria, anti-NMDA receptor encephalitis, lupus, Lyme disease, neuroendocrine tumors, and syphilis—that can masquerade as psychiatric disorders. These illnesses often show up with psychiatric symptoms like anxiety, psychosis, or mood changes, mixed with physical signs such as rashes, abdominal pain, or heart irregularities. Getting the right diagnosis is essential since many cases improve with medical treatment, though you may still need to provide psychiatric care for lingering symptoms. It’s a reminder to stay curious when symptoms don’t quite fit the usual psychiatric picture.