Factitious bereavement with psychotic features in a patient with borderline personality disorder and opium dependence

Factitious disorder, whilst uncommon, is not rare in patients referring to clinics and psychiatric hospital.Concerning high rate of grief reactions in this province after the Bam earthquake in the year 2004, we believe that this condition is Under diagnosed, mainly because of diagnostic difficulties. In current article an unusual case who came with psychotic symptoms accompanied by symptoms of complicated grief is reported. The final diagnosis is supposed to be factitious bereavement.Reported case is a 27 years old man with approved diagnosis of borderline personality disorder and opium dependence. At the last session of hospitalizing in 2010, his symptoms include : irritability, aggression and emphasis on visiting his relatives and some strange people who died in the Bam earthquake about six years ago, in which the patient took part in finding their corpses in collaboration with safety guards.From onset of disturbance, patient claimed that those deceased people are continuously present around him, talk to him and blame him because of his insufficient effort to save them. He also believes that the experiences are real and those people are alive at present. Relationship between factitious disorder with bereavement symptoms is not well-described in literatures, so this patient and influences of personality structure and opium dependence on forming patient's symptoms are discussed in this article.