Abstract

NUNEZ-MOSCOSO, Patricia; DI NATALE-GUEVARA, Milko; POMAREDA-LLANOS, Julio  and  CRUZADO, Lizardo. Apropos of two probable cases of instrumental psychosis. Rev Neuropsiquiatr [online]. 2016, vol.79, n.4, pp.265-271. ISSN 0034-8597.  http://dx.doi.org/10.20453/rnp.v79i4.2981.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines malingering as the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives; under some circumstances, malingering may represent a sort of adaptive behavior. In fact, malingering is not a mental disorder but a problem that may be require clinical attention. Nevertheless, it is erroneously assumed that malingering could only occur in forensic contexts, therefore difficult to identify in clinical settings. “Instrumental psychosis” is a variant of malingering which consists in the intentional production of symptoms by an individual with a diagnosis of primary psychosis, who feigns his/her symptoms during periods of clinical stability. Two cases of patients with a primary diagnosis of schizophrenia and who qualify as apparent cases of instrumental psychosis, are presented. There are no previous reports of this disorder in our country, although presumably its number may not be small. Relevant literature on this interesting clinical phenomenon is reviewed as, beyond itsmere psychopathological content, it seems to reflect behaviors of a definite psychosocial nature.

Keywords : Malingering; factitious disorder; schizophrenia.

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