SIMULATION AND HYSTERY IN PSYCHIATRIC EXPERTISE

Abstract

The expert situation in which the questions of hysteria
and simulation are raised is that of the legal redress of
bodily injury. Simulation situations, that is to say, allegations of psychotraumatic disorders, may be encountered
when the patient does not have any. In this case, the
absence of conclusive evidence and the finding that the
patient does not present genuine disorders, are important
elements to invalidate the existence of a post-traumatic
stress disorder. Cases of conversion disorders or histrionic
personality can meet, and in this case often depend on the
patient’s relational environment, that is to say, a situation
of dependence or rejection of the environment. In this
context, the evaluation of the psychiatric state must take
into account psychic parameters related to the relational
dimension of the patient’s life, which can reinforce or
attenuate the symptomatology, with the idea that even in
the absence of Objectivized anterior state, the elements of
childhood and adolescence can promote the emergence of
psychopathological disorders during a traumatic life event.
In addition to the question of histrionic personality and
conversion disorders, the factitious disorder raises more
questions than simple simulation. Indeed, one could also
consider the simulation as a clinical sign, which would
testify in the person in question of a personality disorder
and therefore of a psychopathology. Registering in a logic of
demand vis-à-vis an institutional third party, whether it is
an insurance or a court, can testify to an immaturity and
a difficulty to register in a psycho-emotional development
able to consider interpersonal relationships constructively