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Medical Litigation News |
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DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FOURTH EDITION [DSM-IV]:
The essential feature of Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives. Malingering should be strongly suspected if any combination of the following is noted:
- Marked discrepancy between the claimed stress or disability and the objective findings
- Lack of cooperation during the diagnostic evaluation and in complying with the prescribed treatment regimen
- The presence of Antisocial Personality Disorder
In Factitious Disorder there is no external incentive but the need to maintain the sick role. In Conversion Disorder (and other Somatoform Disorders including pain amplification), there is no intentional production of symptoms, and symptom are often relieved by suggestion or hypnosis.
PSYCHOLOGICAL ASSESSMENT
The last 2 years have seen a proliferation of research in detecting malingering, notably in the traumatically brain-injured (TBI). With the the refined scales of standard psychological (particularly memory[1]) tests, and the newly developed tests[2], psychologists and neuropsychologists can now confirm or refute malingering with a high degree of confidence.
POST TRAUMATIC STRESS DISORDER
In addition to inconsistencies in the clinical history, features which might indicate malingered post traumatic stress disorder (PTSD) include
- Patchy employment record
- Previous incapacitating illnesses
- Emphasis on reliving symptoms
- Absence of nightmares or sexual dysfunction[3].
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Malingering 1995-6
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Malingering 1999
Chronic Pain
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