Differentiating True and Feigned Insanity

Study Notes

Differentiating True and Feigned Insanity

Onset: True insanity has a gradual onset, feigned insanity has a sudden onset.
Motive: True insanity has no motive, feigned insanity has a motive (e.g., committing a crime)
Predisposing factors: True insanity often has a family history of the illness, feigned insanity does not.
Signs and symptoms: True insanity demonstrates uniform signs and symptoms associated with the specific type of illness, feigned symptoms are not directed to any particular type of illness.
Activity: True insanity patients may be careless and show activity regardless of observation, feigned activity is only shown when observed and may be exaggerated.
Mood: True insanity patients may have varying moods: excited, depressed, fluctuating, while feigned patients may overact to show mood abnormality.
Facial expression: True patients may have peculiar looks (e.g., vacant, agitated, worried), while a feigned patient will display unpredictable facial expressions.
Insomnia: True insanity patients experience insomnia, feigned patients may not persist with insomnia; patients may sleep soundly after a day or two.
Exertion: True insanity patients can usually withstand exertion, while feigned patients cannot sustain physical exertion for extended periods.
Habits: True patients are unaffected by hygiene/habits, feigned patients will often be seen as dirty and unkempt.
Dressing: True insanity patients are appropriately dressed, feigned patients may dress carelessly.
Skin and lips: True patients may have normal skin, feigned patients may have dry, harsh, and dirty skin.
Tongue: True insanity patients may have a coated tongue, while feigned patients have a normal tongue.
Repeated examination: True patients will not mind repeated examinations, feigned patients may resent examination.
Speech characteristics: True insanity may have normal speech characteristics, while feigned patients may show variations in tone, rate, and rhythm in their speech.