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The History of Factitious Disorder

The April 2010 issue of the History of the Human Sciences, which has just been released online, includes an article on the origins of factitious disorder. Authored by Richard A.A. Kanaan of the Institute of Psychiatry in London, and Simon C. Wessely of the Institute of Psychiatry, King’s College London, the article discusses the disorder’s modern development. The abstract reads:

Factitious disorder is the deliberate simulation of illness for the purpose of seeking the sick role. It is a 20th-century diagnosis, though the grounds for its introduction are uncertain. While previous authors have considered the social changes contributing to growth in the disorder, this article looks at some of the pressures on doctors that may have created the diagnostic need for a disorder between hysteria and malingering. The recent history of those disorders suggests that malingering would no longer be acceptable when applied to the potentially larger numbers involved in workers’ compensation or in mass conscription. Equally, the absolution given to hysteria on the basis of the Freudian subconscious would survive only as long as that model retained credibility. Growing egalitarianism and changing doctor—patient relationships in the 20th century would no longer tolerate a sharp division between culpable malingering and exculpated hysteria, which may previously have been made on grounds of class or gender. They would contribute to the need for a mediating diagnosis, such as factitious disorder.

The full April 2010 issue of the History of the Human Sciences can be found here.