Forensic assessment of somatoform and functional neurological disorders 2024 Datta and Blum

Abstract

Functional neurological disorders (FND) and somatization are common in clinical practice and medicolegal settings. These conditions are frequently disabling and, if arising following an accident, may lead to claims for legal compensation or occupational disability (such as social security disability insurance). However, distinguishing FND and somatization from symptoms that are intentionally produced (i.e., malingered or factitious) may pose a major forensic psychiatric challenge. In this article, we describe how somatoform disorders and FND lie along a spectrum of abnormal illness-related behaviors, including factitious disorder, compensation neurosis, and malingering. We provide a systematic approach to the forensic assessment of FND and conclude by describing common litigation scenarios in which FND may be at issue. Forensic testimony may play an important role in the resolution of such cases.

Paywall, https://onlinelibrary.wiley.com/doi/10.1002/bsl.2651

 

Almost annoyed that I can't read it, because wow are the so many layers of wrong. Starting with the word forensic, which is the investigation of a crime. And of course the fact that most forensic "science" has been revealed to be pseudoscience of almost zero validity. Their wild claims of being able to tell the difference are just as absurd as the old lie of 'lie detectors'. They may as well be judges who claim to be able to tell when a witness lies, that's basically the same thing.

They speak of distinguishing (interesting that they don't use differentiating) FND and "somatization" (which obviously means they are the same thing) from symptoms that are intentionally produced, but of course there is no such things as symptoms that are intentionally produced, especially as they mean here factitious. There are only symptoms that can be factitiously reported, but obviously not produced. Are they factitious, or not? If they're internally produced, they can't be factitious. Of course they must mean factitiously reported here, but since the belief system is 'disordered' internal conversion of symptoms out of distress, or whatever, and of course they can't tell the difference in any case, then that's all a big bag of made-up junk, and it's not the patients making it up.

It's odd that they speak of compensation only in the case of accidents, when that's not the only case. But of course if this is driven by insurers, and you can bet that it is, then of course they'll frame it that way. The authors declare no conflict of interest. Right. I bet they feel that way. Just like the MDs who shilled for the tobacco industry. Some of them actually believed it sincerely. I'm sure to their grave. Their large grave with a big expensive tombstone, bought with blood money.

And of course they can't really help but slip the mask, and place factitious disorder on the spectrum of FND/somatization, which literally all means the same thing: I, MD, cannot confirm your symptoms as part of a diagnosis that I, and my peers in general, accept as valid. So as usual, this is diagnosis based on the beliefs of the MD, not anything to do with what is happening to the patients.

But of course they'll still pretend that factitious disorder, which is just a fancy shmancy term for fraud, being part of the spectrum of FND doesn't mean that FND is factitious. No, of course not. They're not calling you a prostitute, they're merely saying that you take money in exchange for sex with strangers. Totally different.

It's really scary how deep and absurd this is. There is not even anything else close to it in any other profession. The closest would actually be forensic science, in criminology, and that was widely accepted as being iffy soft science at best, now mostly debunked, although quite a few lives have been ruined by assertions otherwise.

 

A few quotes —

Clinical Context

Related behaviors

Approach to the forensic evaluation

Psychological testing

Personal injury litigation

Medical malpractice