Factitious Disorders are characterized by physical or psychological symptoms that are intentionally produced or feigned in order to assume the sick role. The judgment that a particular symptom is intentionally produced is made both by direct evidence and by excluding other causes of the symptom. For example, an individual presenting with hematuria is found to have anticoagulants in his possession. The person denies having taken them, but blood studies are consistent with the ingestion of anticoagulants. A reasonable inference, in the absence of evidence that accidental ingestion occurred, is that the individual may have taken the medication intentionally. It should be noted that the presence of factitious symptoms does not preclude the coexistence of true physical or psychological symptoms.