Pseudologia Fantastica: A Systematic Review of Sociodemographic Features and Psychiatric Comorbidities
V. Sharma, R. K. Suri, T. Kainth, M. Salehi, G. Gill, K. Tran, S. GunturuIntroduction
Pseudologia fantastica (PF), also referred to as pathological lying in literature, consists of fantastically fabricated distortions with no apparent reason or personal gain. PF is not recognized as an independent clinical entity in the DSM-V, resulting in a diagnostic challenge and significant legal implications for competency assessment to stand trial.
Objectives
Discuss demographics, intention and content of the fabrications, reaction on confrontation, psychiatric comorbidities and concurrent substance abuse associated with pseudologia fantastica through a systematic review and qualitative analysis.
Methods
We conducted a systematic search through 3 databases - PubMed, PsycINFO, and Scopus, to discuss the demographics, substance use, dynamics of the lies told by the patients with PF, and their psychiatric comorbidities. After applying inclusion and exclusion criteria for the title, abstract, and full-text assessments, we included a total of 34 articles consisting of 55 cases of PF in our final study. PRISMA guidelines were followed throughout (Figure 1).
Results
A total of 55 cases from existing literature were selected and evaluated. Approximately 49% of pseudologues presented in their 3rd and 4th decade of life with a marked male predominance (72.73%). The three leading motives behind the fabrications seemed to be self-aggrandizing (38.18%), seeking attention (36.36%), and assumption of a sick role (29.09%). Exaggerations about life events (38.18%), education, and occupation (43.64%) closely followed health-related lies (67.27%) closely (Figure 2). Pseudologues assumed a different name/identity (32.73%), which posed serious legal ramifications. The most common psychiatric comorbidities associated with PF were cluster B personality disorders (25.45%), depressive disorders (16.36%), trauma/stress disorders (16.36%), and somatic and factitious disorders (14.55%) (Figure 3). Pseudologues also exhibited high suicidality (27.27%), with 16.36% attempting suicide. Substance abuse was also prevalent (30.91%), with significant alcohol use disorder (21.82%).
Image 1: Long description.