Intentional production of symptoms: a narrative review

Objective: Illness deception or the intentional production of symptoms holds special significance in the mental-health field. Mental health professionals need to be aware about the various presentations of such cases, including how to identify and manage them. Further, management is also complicated by several ethical and legal issues. Methods: A narrative review covering the various aspects of intentional production of symptoms is presented here, with articles searched at pubmed-indexed literature, supplemented with cross reference search and manual search of title/abstract of relevant articles, using suitable key words. Results: Overall, relatively few publications were found from the more recent years. The prevalence of intentional production of symptoms seems substantial, yet is likely to be undetected in the majority of the cases. The boundary of the current conceptualization of illness behavior/intentional production of symptoms is blurred and warrants further exploration with well-designed studies and robust debate. Clinical interview is the cornerstone of assessment. Further, psychological tests are available for detecting illness deception, which may be employed. Conclusion: Clinicians should consider a possibility of illness deception whenever is in doubt and extreme care needs to be taken in documenting such cases. Further research is needed in this area to clarify the current controversies in the concept of this entity to help in better detection, and objective assessment of such cases