title: [Simulation in the general hospital: differential diagnosis and policy].
abstract: Doctors meet patients who present with non-genuine diseases. We present three patients who present with an illness with no organic cause: conversion syndrome, factitious disorder and simulation. We discuss the differential diagnosis, prevalence and diagnostics in the event of simulation. A proposal is made about how to respond in the event of simulation. The method is similar to the treatment of a factitious disorder: limitation of the potential benefits attached to the sick role; confrontation with medical facts; maintaining the doctor-patient relationship.
authors.affiliation: GGZ inGeest, Amsterdam, the Netherlands. au.vanschaik@ggzingeest.nl
authors.forename: Audrey M
authors.initials: AM
authors.lastname: van Schaik
authors.forename: Josien G
authors.initials: JG
authors.lastname: van Mill
authors.forename: Bregje A
authors.initials: BA
authors.lastname: Appels
authors.forename: Willem
authors.initials: W
authors.lastname: van Tilburg
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005162:Factitious Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011570:Psychiatry; D012017:Referral and Consultation; D012307:Risk Factors; D012803:Sick Role