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Feigned psychosis revisited –a 20 year follow up of 10 patients

Published online by Cambridge University Press:  02 January 2018

Martin Humphreys*
Affiliation:
Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF
Alan Ogilvie
Affiliation:
MRC Brain Metabolism Unit, Royal Edinburgh Hospital
*
Correspondence
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Abstract

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Feigned psychosis, although rare, presents considerable diagnostic problems in clinical psychiatric practice. Long-term follow up data are lacking. A retrospective case note study was undertaken of 10 patients described in a previous paper, published in 1970, on the simulation of psychosis. The computerised diagnostic instrument OPCRIT was applied to both index episode and lifetime occurrence of symptoms. All 10 patients were found to have had a major psychotic illness based on lifetime symptoms at 20 year follow-up by DSM–III–R criteria. Eight had met such criteria at the time of the initial episode. Diagnosis in patients thought to be feigning psychotic symptoms changes over time and major mental illness is likely to emerge which may be schizophrenic or affective. The term feigned psychosis should be abandoned and more attention given to why symptoms are accepted as genuine in some cases but not others.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1996 The Royal College of Psychiatrists

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM–IV). Washington, DC: APA.Google Scholar
Bark, N. M. (1985) Did Shakespeare know schizophrenia? The case of Poor Mad Tom in King Lear. British Journal of Psychiatry, 146, 436438.CrossRefGoogle ScholarPubMed
Beck, T. R. (1829) Elements of Medical Jurisprudence. Edinburgh: Londman Rees.Google Scholar
Ganser, S. J. (1898) Ueber einen eigenartigen hystrischen Daemmerzustand. Archiv für Psychiatrie und Nerven Krankheiten, 30, 633. (Translated by Shorer, C. E. (1965) British Journal of Criminology, 5, 120.)CrossRefGoogle Scholar
Hay, G. G. (1983) Feigned psychosis – a review of the simulation of mental Illness. British Journal of Psychiatry, 143, 810.CrossRefGoogle ScholarPubMed
Hill, G. N. (1814) An Essay on the Prevention and Cure of Insanity with Observations and Rules for the Detection of Pretenders to Madness. London.Google Scholar
Jonas, J. M. & Pope, H. G. (1985) The dissimulating disorders: a single diagnostic entity? Comprehensive Psychiatry, 26, 5862.CrossRefGoogle ScholarPubMed
Jones, E. H. (1955) The Road to En-Dor. London: Pan Books.Google Scholar
Jung, C. G. (1903) On simulated insanity. In Collected works of C. G. Jung Vol I. (1957). London: Routledge and Kegan Paul.Google Scholar
Lewis, G. & Appleby, L. (1988) Personality disorder the patients psychiatrists dislike. British Journal of Psychiatry, 153, 4449.CrossRefGoogle Scholar
McGuffin, P., Farmer, A. E. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 46, 764770.CrossRefGoogle Scholar
Pope, H. G., Jonas, J. M. & Jones, B. (1982) Factitious psychosis: phenomenology, family history and long term outcome of nine patients. American Journal of Psychiatry, 139, 14801483.Google ScholarPubMed
Reid, P. R. (1952) The Colditz Story. London: Hodder & Stoughton.Google Scholar
Ritson, B. & Forrest, A. (1970) The simulation of psychosis: a contemporary presentation. British Journal of Medical Psychology, 43, 3137.CrossRefGoogle ScholarPubMed
Rogers, R., Bagby, R. M. & Rector, N. (1989) Diagnostic legitimacy of factitious disorder with psychological symptoms. American Journal of Psychiatry, 146, 13121314.Google ScholarPubMed
Schneck, J. N. (1970) Pseudo malingering and Leonid Andreyev's The Dilemma. Psychiatric Quarterly, 44, 4954.CrossRefGoogle Scholar
Scott, P. D. (1965) Commentary on Shorers translation of The Ganser Syndrome. British Journal of Criminology, 5, 127131.Google Scholar
Slater, E. (1961) “Hysteria 311” 35th Maudsley Lecture. Journal of Mental Science, 107, 359381.CrossRefGoogle Scholar
Slater, E. (1965) Diagnosis of “Hysteria” British Medical Journal 1, 13951399.CrossRefGoogle ScholarPubMed
Szasz, T. S. (1987) Insanity – The Idea and Its Consequences. New York: Wiley.Google Scholar
World Health Organization (1992) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD–10). Geneva: WHO.Google Scholar
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