Category · F60-F69 block
F68 — Other disorders of adult personality and behaviour
Terminology note: F68.1 (factitious disorder) is the direct counterpart to F44/F45's genuine, involuntary symptoms and to malingering (conscious feigning for an external, material incentive, which is not itself a mental disorder) — completing a three-way reasoning distinction begun in F40-F48.
What is this category?
F68 groups two named presentations. F68.0 covers elaboration of physical symptoms for psychological reasons: a person with a genuine physical disorder unconsciously exaggerates or prolongs its associated symptoms for psychological reasons, such as to obtain attention or support. F68.1 (factitious disorder) covers the intentional, conscious production or feigning of symptoms or disabilities, repeatedly and without an external incentive, driven instead by an internal psychological need (such as assuming the role of a patient).
Core diagnostic concept
The decisive three-way distinction this category completes is: a genuine, involuntary symptom (F44/F45, produced unconsciously, not under voluntary control); a factitious symptom (F68.1, consciously and intentionally produced, but for an internal psychological need with no external material incentive); and malingering (consciously and intentionally produced for an external, material incentive such as financial compensation or avoiding legal responsibility — not itself a mental disorder at all). Confusing any two of these three leads to a fundamentally different, and often harmful, classification error.
Key diagnostic features
- F68.0: unconscious exaggeration of a genuine physical disorder's symptoms
- A real underlying physical disorder is present, but its associated symptoms are unconsciously exaggerated or prolonged for psychological reasons.
- F68.1: conscious, intentional production of symptoms
- Symptoms or disabilities are deliberately and consciously produced or feigned, distinguishing this from F44/F45's involuntary presentations.
- F68.1: no external material incentive
- The motivation is an internal psychological need (such as assuming a patient role), not an external material incentive like financial gain or avoiding a legal obligation — which would instead indicate malingering, not a mental disorder.
How to weigh evidence
These learning labels are teaching aids, not official ICD-10 terminology (see Sources and Method).
- supports Clear evidence of deliberate, conscious production or feigning of symptoms (e.g. self-inflicted findings, contradictory or evasive accounts, medical evidence inconsistent with a genuine disease process), with no identified external material incentive.
- consistent not decisive A person's symptom presentation is difficult for clinicians to fully explain, without any specific evidence of deliberate production either way.
- raises alternative A clear external material incentive is present, such as pending financial compensation, disability benefits, or avoiding a legal or work obligation, which points toward malingering rather than a mental disorder.
- contradicts or weakens The symptoms are unconsciously produced and not under the person's voluntary control, pointing instead toward a genuine dissociative or somatoform presentation (F44/F45).
- missing and necessary to ask Whether the symptom production is conscious or unconscious, and, if conscious, whether an external material incentive is present.
Diagnostic boundary
F68.1 requires conscious, intentional symptom production for an internal psychological need with no external material incentive — genuine involuntary symptoms point to F44/F45, and conscious production for external gain points to malingering, not a mental disorder.
Full comparisons:
Duration and course
Minimum duration: Not fixed by a single universal threshold; the pattern can be a single episode or recurrent over time.
Course: Can involve repeated presentations, sometimes across different providers or settings.
Included presentations
- Elaboration of physical symptoms for psychological reasons: unconscious exaggeration or prolongation of a genuine physical disorder's symptoms for psychological reasons.
- Factitious disorder: intentional, conscious production or feigning of symptoms or disabilities, repeatedly, with no external material incentive.
Exclusions and distinguishing presentations
| If this is true instead… | Consider | Why |
|---|---|---|
| Genuine, unconsciously produced dissociative or somatoform symptoms, not under voluntary control | F44 | F68.1 requires conscious, intentional production — a genuine involuntary symptom points to F44/F45 instead. |
| Conscious, intentional symptom production specifically for an external material incentive (financial compensation, avoiding legal or work obligations) | genuineness of symptoms capsule | Conscious production for an external material incentive is malingering, which is not itself classified as a mental disorder in this system. |
Four-character subtypes (orientation)
A learner should check consciousness of production (conscious vs. unconscious) and the presence or absence of an external material incentive before choosing between F68.1, F44/F45, and malingering — these three are easily confused but require fundamentally different responses.
- F68.0 — Elaboration of physical symptoms for psychological reasons
- Unconscious exaggeration of a genuine physical disorder's symptoms for psychological reasons. (in_depth)
- F68.1 — Intentional production or feigning of symptoms or disabilities (factitious disorder)
- Conscious, intentional symptom production for an internal psychological need, no external incentive. (in_depth)
- F68.8 — Other specified disorders of adult personality and behaviour
- A presentation not matching the named subtypes. (taught for orientation only, not separately assessed in this pilot)
External causes to check first
Categories in this block require that the disturbance is not better explained by another external cause listed below. These short capsules are reminders, not full teaching modules.
External cause capsule — Genuineness of dissociative and somatoform symptoms
A reminder that dissociative [conversion] and somatoform symptoms are not intentionally or consciously produced by the person experiencing them, which is what separates a genuine F44 or F45 presentation from malingering (conscious feigning for an external incentive, such as a compensation claim or avoiding an obligation) or factitious disorder (conscious feigning for an internal psychological need), both of which fall outside this block's scope.
What to check:
- Evidence of a specific, identifiable external incentive (financial, legal, or avoidance of a specific obligation) actually driving the presentation, rather than an incentive merely being hypothetically possible.
- Whether the symptom pattern is consistent with what is known about genuine dissociative or somatoform presentations, or instead closely tracks what would maximise the suspected external benefit.
- Absence of an identifiable incentive, and a symptom pattern consistent with genuine dissociative or somatoform presentations, both weigh toward a genuine disorder rather than feigning.
- The default assumption, absent specific evidence to the contrary, should be that the person's distress and symptoms are genuine.
A full clinical assessment of secondary gain or a forensic evaluation, both of which require specialised judgement and evidence well beyond what a single vignette can establish.
Worked example — factitious disorder versus malingering
A patient has presented to multiple hospitals over several years with recurrent, dramatic symptoms that investigations repeatedly fail to substantiate, and on one occasion staff discovered evidence that the patient had deliberately tampered with a diagnostic sample to produce an abnormal result. The patient has no pending legal case, disability claim, or other identifiable financial or material incentive, and appears to derive no benefit beyond extensive medical attention and repeated hospital admission.
- Step 1 — Establish conscious production: deliberate tampering with a diagnostic sample confirms the symptoms are being intentionally produced, not unconscious.
- Step 2 — Check for an external material incentive: none is present — no pending legal case, disability claim, or financial motive.
- Step 3 — Identify the apparent function: extensive medical attention and the patient role itself, an internal psychological need.
- Conclusion — F68.1, Factitious disorder — conscious production, no external material incentive, and an apparent internal psychological need together distinguish this from both a genuine involuntary presentation and from malingering.
Interactive practice
- Type A Tampering with the sample Recognition / application · Foundation
- Type B Feigned, but why? Boundary discrimination · Transfer
Retrieval prompts
Try answering each of these from memory before revealing where to check. Nothing you think or type here is sent or saved anywhere.
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Name the three-way distinction F68.1 sits within, and state what separates each from the other two.
Reveal answer location
Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.
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Explain why malingering is not itself classified as a mental disorder.
Reveal answer location
Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.
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State the single piece of evidence that would most shift a case from factitious disorder toward malingering.
Reveal answer location
Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.
These self-checks are a personal study aid only, visible to you on this page for this visit — they are not stored and do not affect your mastery dimensions.
Rapid revision card
F68: F68.1 requires conscious symptom production for an internal psychological need with no external material incentive — distinct from both genuine involuntary symptoms (F44/F45) and malingering (external incentive, not a mental disorder).
Decisive boundary cues:
- Conscious production, no external incentive, apparent internal need -> weighs toward F68.1.
- Unconscious, involuntary production -> weighs toward F44/F45 instead.
- Conscious production with a clear external material incentive -> weighs toward malingering, not a mental disorder.
Duration/course: Can be a single episode or recurrent over time; not defined by a fixed duration threshold.
Nearest alternatives: f44, f45
Common mistake: Assuming any case of doubted or unsubstantiated symptoms must be either a genuine dissociative/somatoform presentation or straightforward malingering, without checking for factitious disorder's specific pattern.
Retrieval prompt: Is symptom production conscious or unconscious, and is there an external material incentive?
(or use your browser's print function) Open full-page printable revision view →
Related glossary terms
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Factitious disorder
The intentional production or feigning of symptoms or disabilities, either physical or psychological, in the absence of any external incentive, apparently for the purpose of assuming the sick role. Classified under F68.1, and distinguished from malingering by the absence of an external incentive such as compensation or avoiding an obligation.
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Malingering
The intentional production or exaggeration of symptoms, motivated by an external incentive (such as financial compensation, avoiding an unwanted obligation, or evading legal consequences). Not itself a mental disorder and has no ICD-10 F-code of its own; referenced here as the necessary contrast to F68.1 (factitious disorder) and to genuine, involuntary symptom presentations.
Source basis
WHO ICD-10 international classification structure and code/title (ICD-10 Browser, 2019 English release).
Original educational synthesis, informed by general published clinical-education understanding of ICD-10 F60-F69; no verbatim CDDG or DCR text is reproduced. See Sources and Method for the full policy.
Last reviewed: 2026-09-17. Full policy: Sources and Method.
Educational resource only. This page and its cases teach ICD-10 classification reasoning using fictional scenarios. It does not diagnose real people and should not be used to assess yourself or anyone else. A person's gender identity or sexual orientation is not itself a disorder. If you or someone you know is struggling with a pattern of behaviour, an urge you find hard to control, or distress related to discrimination or how you are treated by others, please seek prompt, respectful professional support.