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Malingering

Definition

Malingering is when a person exaggerates or makes up a physical or psychological illness or injury to seek personal gain (such as paid sick leave, worker's compensation, avoiding military duty, obtaining financial compensation, obtaining drugs). It is a voluntary behavior directed toward achieving a certain goal. It is not thought to be a form of mental illness. But it can exist in the context of other mental illnesses.

Causes

Malingering is not considered a mental disorder. It occurs when a person intentionally fakes symptoms for personal gains. It is caused by external factors that motivate the malingering. It is often associated with antisocial personality disorder.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
Malingering often occurs in the work environment. It also occurs when there are legal disputes that involve money and medical issues.

Symptoms

Signs of malingering include:
  • Unwilling to have recommended tests
  • Failure to comply with prescribed treatments
  • Inconsistency between reported symptoms and physical findings on a medical exam

Diagnosis

There is no way to definitively diagnose malingering. The diagnosis focuses on ruling out true physical or mental causes of symptoms. Psychological assessments can also help rule out other disorders, such as Munchausen's syndrome. Depending on reported symptoms, exams may be done and tests may be ordered to look for real physical illnesses.

Treatment

Since it is not a true illness, there is no real treatment for malingering. When malingering is suspected, the doctor may:
  • Discuss the findings—If a doctor's findings do not match the symptoms and if malingering is suspected, the doctor may confront the patient.
  • Psychiatric consultation—If a psychiatric disorder is suspected, the patient may be referred to a mental health professional.

Prevention

Malingering is not a mental disorder. It can be prevented by making the decision not to exaggerate or make up symptoms for personal gain.

RESOURCES

American Psychiatric Association http://www.healthyminds.org

Mental Health America http://www.mentalhealthamerica.net

CANADIAN RESOURCES

Canadian Mental Health Association http://www.cmha.ca

Canadian Psychiatric Association http://www.cpa-apc.org

References

Greer S, Chambliss L. What physical exam techniques are useful to detect malingering? J Fam Pract. 2005;54.

Rogers R. Clinical Assessment of Malingering and Deception. New York, NY: Guilford Press; 1988.

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