Objectives. A differentiation between malingering and dissimulation in a case of schizophrenia is presented.
Case. 30-year-old patient treated on the outpatient basis for paranoid schizophrenia in the past 3 years was receiving a welfare benefit on the grounds of this diagnosis. In 2006 he was admitted to a closed ward for a 6-week forensic psychiatric observation on a charge of punishable threats (he had threatened to kill his neighbor, which was irrelevant to his psychotic disorder). In the course of observation he presented a dissimulating attitude denying his psychotic symptoms. The psychotic symptoms he had reported prior to his hospitalization the patient explained by his strategy of purposeful malingering. He pleaded not guilty to the charge.
Commentary. The diagnosis of schizophrenia was confirmed by an analysis of the overall clinical picture in this case.