Factitious posttraumatic stress disorder: the veteran who never got to Vietnam.

The historical uniqueness of the Vietnam War produced an unusually high rate of psychiatric dysfunction among veterans, particularly in the form of posttraumatic stress disorder (PTSD). Now, in the wake of unprecedented media coverage of PTSD and the growth of veteran outreach centers documenting and publicizing the difficulties of some veterans, a heretofore unrecognized variant of PTSD-factitious PTSD--has arisen. The authors present seven cases of factitious PTSD, a classic example of clinical deception found among veterans who were never in combat and, in some cases, were never in Vietnam. The authors discuss the etiologies of the disorder and the underlying psychopathology, which suggests either factitious syndromes, such as Munchausen's, or malingering. They conclude with recommendations for diagnosis and treatment.