Réalité de la maladie organique ou pathomimie : de l'énigme au secret

The pathomimia are a factitious disorder characterized by a self-produced symptom by a patient. The essential psychological motivations being to challenge the other, particularly, the physician. The patients keep their history secret and cannot say anything. Clinical aspects are highly variable and the positive diagnosis for the physician are very difficult (differential diagnoses are numerous) particularly when the pathomimia are overloading an organic pathology (CRPS). It is necessary to try to limit invasive testing or therapeutic. Often diagnosis by exclusion can be made based on the judgment of the medical and psychological or psychiatric team. The suspicion and the positive diagnostic can unleash anger directed toward patient from the medical team. But it is important to make a caring treatment atmosphere for the patient's evolution.