DSM-5 must emphasize that physical symptoms deserve the respect of a thorough work-up before assuming their cause is psychiatric. And people with defined medical illnesses should not be casually mislabeled as also mentally ill just because they are upset about being sick.
This tale involves a “clever” inmate. He enjoyed the respectable rung of bank robber, but found he had suddenly descended to approximately the level of a sex offender. The reason for his slippage was the inmate code, which demands allegiance to other inmates under virtually all circumstances. “Ratting out” a fellow inmate may cost one his life, or at the very least, result in a decidedly anxious, paranoid existence.