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CONy 2024 | The difference between functional cognitive disorder and feigned cognitive impairment

Feigned cognitive complaints or exaggeration pose a challenge in the accurate diagnosis of functional cognitive disorder (FCD). Narinder Kapur, PhD, Dip Psych, University College London, London, UK, comments on how feigned illness can be differentiated from FCD, highlighting the two types of feigning that exist and how to identify patients who may be feigning symptoms. Factitious disorder is internally driven and is a type of feigning in which individuals may try to draw attention to their symptoms from medical staff, as they hold the belief that they suffer from a major medical disorder. The second type of feigning, termed malingering, is associated with an external incentive, such as financial gain or getting out of the army or prison. Therefore, in order to identify whether an individual is feigning, clinicians should first examine whether there are any internal or external reasons that could lead to feigning. Additionally, they should look for implausible symptoms, such as prosopagnosia and claiming to remember recent events but not childhood memories. Finally, the use of performance validity tests allows deliberate underperformance in cognitive tests to be identified. This interview took place at the 18th Annual Congress on Controversies in Neurology (CONy 2024) in London, UK.

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