PT - JOURNAL ARTICLE AU - CR Thompson AU - M Beckson TI - A case of factitious homicidal ideation DP - 2004 Sep 01 TA - Journal of the American Academy of Psychiatry and the Law Online PG - 277--281 VI - 32 IP - 3 4099 - http://jaapl.org/content/32/3/277.short 4100 - http://jaapl.org/content/32/3/277.full SO - J Am Acad Psychiatry Law2004 Sep 01; 32 AB - Homicidal ideation is often fabricated or embellished by psychiatric patients in both the emergency room and inpatient settings. Typically, this symptom is malingered to achieve short-term hospital admission and temporary relief from complications of substance abuse, homelessness, and illicit activities. Very rarely, a patient may feign homicidal intent for the primary purpose of remaining in the role of patient (factitious disorder). Although factitious disorder with psychological symptoms has been described in a variety of circumstances, the psychiatric literature lacks any reports of factitious homicidal ideation. This is a report on the case of a patient who was civilly committed on numerous occasions for protracted periods based solely on his self-professed homicidal ideation. The case raises both forensic and clinical questions and reinforces the authors' belief that further investigation is needed to develop more sophisticated methods of detection, evaluation, and treatment of factitious disorder with psychological symptoms.