Severe depression when everything else is dismissed. A case

Abstract

Introduction

Simulation is a deliberate counterfeiting of physical or psychological symptoms in order to obtain a secondary gain or external incentive, like evading from military service, scape from work, obtain economic compensations or avoid criminal responsibility. It is estimated that prevalence is roughly 1% in mental health patients, with higher prevalence in young males and middle aged. Male with 52 years attends to emergency service. Erratic tracking in Mental Health Service from two years ago with unfavorable progress. He goes to emergency service referring aggravation of discomforted state of mind even with readjustment a week ago. Addiction to benzodiazepines and clinophilia. Currently with temporary inability to work of large data.

Objectives

To set a differential diagnose between depression, factitious disorder and malingering.

Methods

Examination shows moderated sad mood with despair, reactive to disability and progression of his illness. Sparing in words speech, focused on life or work problems. Autolytic verbalizations and self-control inability.

Results

Mmpi2 that shows: Gough’s F-K. Dissimulation index, 34. Cut-off point to consider simulation/ pretending being ill varies among authors. A conservative cut-off point is 15, showing a severe exaggeration of its discomfort and dissimulation.

Conclusions

It is important to make an appropriate anamnesis and psychopathological exploration, as well as observation to reach a correct diagnose. In this case, clearly secondary gain was founded, therefore diagnose was malingering.

Disclosure

No significant relationships.