"I have never taken drugs" (Pseudologia Fantastica in ED (case study)

[Chip (OP)]

source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442346/

Pseudologia Fantastica in the Emergency Department: A Case Report and Review of the Literature

Abstract

Psychiatrists commonly encounter deception in the emergency department. This article presents the case of a patient who presents to the emergency department with an unusual and elaborate web of deceptions along multiple themes including feigning medical illness, multiple losses, and grandiose academic and athletic achievements. We review the clinical characteristics of pseudologia fantastica and discuss how this patient's constellation of malingering, factitious disorder, and personality disorder suggests this diagnosis.


Introduction

Pseudologia fantastica, a fascinating psychiatric syndrome where patients represent certain fantasies as real occurrences, has received little attention in the English literature: there are fewer than thirty case reports in the English literature. Pseudologia fantastica goes by multiple different names including pathologic lying and mythomania. In this case report and discussion, we begin by providing a case that illustrates pseudologia fantastica and then discuss the phenomenologic, nosologic, psychodynamic, and treatment issues of this construct.

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