Malingered psychosis

Abstract

The diagnosis of mental illness is heavily reliant on both the honesty and the accuracy of patient statements. Traditionally the veracity of such statements has been assumed; however, particularly in the forensic field, such an assumption may often prove to be naive. The case-example that follows concerns a man convicted of indecently assaulting a teenage boy. He presented to forensic services with a variety of psychotic symptoms, which were subsequently proven to be feigned. The case exemplifies certain typical features of malingered psychosis as described in the American literature; however, it is also unusual in a number of ways. It serves to demonstrate that the careful assessment of possible malingering is a fundamental issue for all psychiatrists, especially where the therapeutic alliance may be complicated by external sociolegal issues which could possibly serve as motivation for the fabrication of psychopathology.

Keywords:

• Malingering
• Psychosis
• Forensic
• Fabrication