Malingering

Definition

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

Causes

Malingering is not considered a mental disorder, since it occurs when a person intentionally fakes symptoms for personal gains. It is caused by whatever 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:

Reluctance to undergo 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, other tests may include:

Physical exam
]]>Magnetic resonance scan (MRI)]]> —a test that uses magnetic waves to make pictures of structures inside the body; used to find any type of abnormality (eg, tumors, lesions) in the brain

MRI Scan

Treatment

Since it is not a true illness, there is no real treatment for malingering. But 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, so 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.ontario.cmha.ca/index.asp

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

References:

Bienenfield D. Malingering. Emedicine website. Available at: http://www.emedicine.com/MED/topic3355.htm .

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

Malingering. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed July 2, 2007.

Last reviewed November 2008 by ]]>Theodor B. Rais, MD]]>

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.