Malingering

Malingering
SpecialtyPsychiatry, clinical psychology
Differential diagnosisFactitious disorder, somatization disorder

Malingering is the fabrication, feigning, or exaggeration of physical or psychological symptoms designed to achieve a desired outcome, such as personal gain, relief from duty or work, avoiding arrest, receiving medication, or mitigating prison sentencing. It presents a complex ethical dilemma within domains of society, including healthcare, legal systems, and employment settings.[1][2][3]

Although malingering is not a medical diagnosis, it may be recorded as a "focus of clinical attention" or a "reason for contact with health services".[4][2] It is coded by both the ICD-10 and DSM-5. The intent of malingerers vary. For example, the homeless may fake a mental illness to gain hospital admission.[5] Impacts of failure to detect malingering are extensive, impacting insurance industries, healthcare systems, public safety, and veterans' disability benefits. Malingered behaviour typically ends as soon as the external goal is obtained.[6]

Malingering is established as separate from similar forms of excessive illness behaviour, such as somatization disorder, wherein symptoms are not deliberately falsified. Another disorder is factitious disorder, which lacks a desire for secondary, external gain.[7][6] Both of these are recognised as diagnosable by the DSM-5. However, not all medical professionals are in agreement with these distinctions.[8]

  1. ^ "malingering". Malingering. Gale Encyclopedia of Medicine. 2008. Retrieved November 5, 2019 – via The Free Dictionary.
  2. ^ a b "QC30 Malingering". ICD-11 for Mortality and Morbidity Statistics. International Classification of Diseases (11th ed.). World Health Organization. April 2019. Retrieved November 5, 2019.
  3. ^ Association, American Psychiatric (2016). DSM-5® classification. American Psychiatric Association. ISBN 978-0-89042-566-4. OCLC 969741924.
  4. ^ Bienenfield, David (April 15, 2015). "Malingering". Medscape. WebMD LLC. Archived from the original on December 30, 2016. Retrieved December 30, 2016. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), malingering receives a V code as one of the other conditions that may be a focus of clinical attention.
  5. ^ "How to distinguish between malingering, genuine psychosis". www.healio.com.
  6. ^ a b Alozai, Ubaid ullah; McPherson, Pamela K. (2023), "Malingering", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29939614
  7. ^ Fogel, Barry S.; Greenberg, Donna B. Psychiatric Care of the Medical Patient. Oxford University Press. doi:10.1093/med/9780199731855.003.0037. ISBN 978-0-19-973185-5.
  8. ^ Rogers, Richard, ed. (2008). Clinical assessment of malingering and deception (3rd ed.). New York: Guilford Press. ISBN 978-1-59385-699-1. OCLC 175174373.