Simuleren in de DSM: Een recept voor misdiagnostiek

When confronted with diagnostic questions, clinicians may feel tempted to rely on stereotypical ideas about diagnoses. Such ideas may improve clinical judgment when they have a strong predictive value. However, their use may be problematic when grounded in misconceptions. One deeply rooted misconception can be found in the dsm section on malingering. This section stresses a strict demarcation between malingering and the somatic symptom- and related disorders, traditionally known as hysteria. A central assumption is that malingering is particularly common in patients with antisocial personality features who intentionally deceive others, while hysteria is ascribed to the unconscious. That blindly relying on the dsm may invite misdiagnosis of a plethora of symptoms is the topic of this article.