Confabulation vs Lying — MRCPsych Paper B MCQ

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EasySubstance MisuseConfabulation vs LyingMRCPsych Paper B

A patient with Korsakoff syndrome gives a detailed but factually incorrect account of recent events and appears convinced that the account is accurate. Which feature best distinguishes confabulation from lying?

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Correct answer: D — The account is produced without conscious intent to deceive

Explanation lettering: E = shown as B · D = shown as C · B = shown as D · C = shown as E

Confabulation is the production of false or distorted memories without a conscious intention to deceive. The patient commonly accepts the account as true because of impaired memory retrieval and reality monitoring. This contrasts with lying, in which the person knows that the account is false and deliberately intends to mislead. Avoiding consequences (A) and obtaining external gain (E) imply conscious deception. Confabulation is associated with amnestic and frontal-system disorders and is not restricted to acute alcohol intoxication (C). It also does not require hallucinations (D), which are false perceptions rather than false recollections. Although classically associated with Korsakoff syndrome, confabulation is not invariably present and is not pathognomonic of the chronic syndrome.

Reference: Francis C, MacCallum F, Pierce S. Interventions for confabulation: A systematic literature review. Clinical Neuropsychologist. 2022;36(8):1997–2020. https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr185.pdf?sfvrsn=66534d91_2