Document Detail

J.-M. Charcot and simulated neurologic disease: attitudes and diagnostic strategies.
MedLine Citation:
PMID:  17606887     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Neurologists have long wrestled with the diagnosis of elaborated or feigned disease. Studies have not focused on early techniques utilized to diagnose malingering. OBJECTIVE: To analyze cases of purposeful neurologic malingering among patients treated by the 19th century neurologist J.-M. Charcot, describe his attitudes, and study his methods to separate malingering from primary neurologic diseases. METHODS: A study was conducted of Charcot's printed and original documents from the Bibliothèque Charcot, Paris, and added documents on American neurology. RESULTS: Charcot recognized that purposeful simulation occurred in isolation as well as in established neurologic disorders. Charcot was strict with subjects motivated by greed or spite, but showed forbearance and wonder in those who created illness as "art for art's sake." Charcot developed diagnostic equipment that measured inspiratory depth and muscle activity as a strategy to identify malingerers. His approach strikingly contrasted with contemporary military medical treatises on malingering and S.W. Mitchell's civilian neurologic approaches that unmasked patients through more aggressive strategies. CONCLUSION: Charcot provided an academically professional approach to the assessment of neurologic malingering, with a stern, often patronizing attitude, but without categorical condemnation. His diagnostic techniques are echoed by contemporary approaches and emphasized an attention to enhanced and inconsistent patterns of behaviors by malingerers.
Christopher G Goetz
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Publication Detail:
Type:  Biography; Comparative Study; Historical Article; Journal Article    
Journal Detail:
Title:  Neurology     Volume:  69     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-03     Completed Date:  2007-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  103-9     Citation Subset:  AIM; IM    
Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
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MeSH Terms
Attitude of Health Personnel*
Catalepsy / diagnosis
Contracture / diagnosis
Conversion Disorder / diagnosis,  history*,  psychology
Diagnosis, Differential
Diagnostic Techniques, Neurological / history*,  instrumentation
History, 19th Century
Hospitals, Military
Hospitals, Psychiatric
Inpatients / psychology
Malingering / diagnosis,  history*,  psychology
Military Medicine / history,  methods
Military Personnel / psychology
Nervous System Diseases / diagnosis,  history*
Neurasthenia / diagnosis,  history,  psychology
Neurology / history*,  methods
Neurophysiology / instrumentation
Physician-Patient Relations
Personal Name Subject
Personal Name Subject:
Jean-Martin Charcot; Silas Weir Mitchell

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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