DISSIMULATION

DISSIMULATION (Latin dissimulatio - pretense), the concealment, hiding, or obscuring of a disease state or individual symptoms of it. Dissimulation can occur in both somatic and psychiatric diseases (in the latter it has the greatest practical significance). Dissimulation occurs far more frequently than simulation. Patients with mental illness typically resort to dissimulation for the purpose of removing supervision, being released from the hospital, gaining greater freedom of action (for example, to carry out suicide), etc. In somatic patients, the goal-oriented attitude toward health associated with dissimulation most often occurs when seeking to obtain employment, pass professional selection (pilots, drivers, etc.). Mentally ill patients try to appear completely harmless to the physician, deny what their relatives report about them, hide their bad mood, strive to appear cheerful, deny hallucinations, reject their delusional ideas, and casually explain their peculiarities. Dissimulation occurs in melancholic states, in paranoia, paranoid psychoses and reactions, as well as in alcoholic diseases (especially frequently in delusions of jealousy). Since dissimulation often enables patients to achieve their desired goals, one must always be very cautious when issuing various certificates about health. The very question of health and the issuance of the corresponding certificate is always questionable, since usually only mentally ill patients seek certificates about their mental health.