MALINGERING

Course overview

MALINGERING IS FALSIFICATION OR PROFOUND EXAGGERATION OF ILLNESS (PHYSICAL OR MENTAL) TO GAIN EXTERNAL BENEFITS SUCH AS AVOIDING WORK OR RESPONSIBILITY, SEEKING DRUGS, AVOIDING TRIAL (LAW), SEEKING ATTENTION, AVOIDING MILITARY SERVICES, LEAVE FROM SCHOOL, PAID LEAVE FROM A JOB, AMONG OTHERS. IT IS NOT A PSYCHIATRIC ILLNESS ACCORDING TO DSM-5 (DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISEASES, FIFTH EDITION). THE DSM-IV-TR FAILED TO PROVIDE ANY PRECISE CRITERIA BECAUSE MALINGERING IS NOT CONSIDERED A PSYCHIATRIC DIAGNOSIS, BUT THE MANUAL DOES STATE IT IS A CONDITION THAT MAY BE A FOCUS OF CLINICAL ATTENTION. ALTHOUGH MALINGERING WAS EXCLUDED FROM THE INDEX IN DSM-5, IT REMAINS A "V" CODE, AND THE CRITERIA FOR WHEN TO CONSIDER MALINGERING REMAINS UNCHANGED. EXTERNAL (SECONDARY) GAIN IS NECESSARY FOR DIFFERENTIATING MALINGERING FROM FACTITIOUS DISORDER (A DISORDER IN WHICH PATIENT CONSCIOUSLY CREATES PHYSICAL OR PSYCHOLOGICAL SYMPTOMS TO ASSUME THE SICK ROLE, THE PRIMARY GAIN). MALINGERERS SHOW POOR COMPLIANCE WITH TREATMENT AND STOP COMPLAINING ABOUT THE ASSUMED ILLNESS ONLY AFTER GAINING THE EXTERNAL BENEFIT. THIS ACTIVITY REVIEWS THE COMMON PRESENTATION OF PATIENTS THAT ARE MALINGERING AND DISCUSSES THE ROLE OF THE INTERPROFESSIONAL TEAM IN EVALUATING AND TREATING THIS CONDITION.