Pseudologia fantastica: a systematic review of sociodemographic features and psychiatric comorbidities.

BACKGROUND

Pseudologia fantastica (PF), or pathological lying, involves elaborate fabrications without clear external gain. Despite its clinical significance, PF lacks recognition in the DSM-5, posing diagnostic and legal challenges.

MATERIALS AND

METHODS

A systematic search of PubMed, PsycINFO, and Scopus identified studies on PF demographics, motives, comorbidities, and outcomes. After applying inclusion and exclusion criteria, 34 articles comprising 55 cases were analyzed.

RESULTS

PF predominantly affected men (72.7%), presenting in the third to fourth decades. Major motives included self-aggrandizement (38.2%), attention-seeking (36.4%), and sick-role assumption (29.1%). Common themes were health-related lies (67.3%) and occupational or educational fabrications (43.6%). Cluster B personality disorders (25.5%), depressive disorders (16.4%), and trauma-related disorders (16.4%) were frequent comorbidities. Suicidality (27.3%) and substance use (30.9%) were notable.

CONCLUSION

PF significantly impacts social, occupational, and legal functioning. Early recognition and clinician-legal awareness are essential for appropriate management.