Fictitious twins, factitious illness

Five patients who sought hospitalization with factitious illnesses also feigned or fantasied loss of a twin. This unusual presentation suggests the possibility that fantasied twin loss may have dynamic implications. The patients are described and discussed in relation to factitious illness, factitious bereavement, and twin fantasies. Their fictional twin bereavement appeared aimed, in part, at stabilizing a fragile sense of self and gaining sympathetic support from others. This presentation should alert one to investigate the story, inviting the person's participation in gaining corroborating information, and--should the story prove false--to support the individual in less victimizing adaptations.