Malingering
| Malingering | |
|---|---|
| Specialty | Psychiatry, psychology  |
Malingering is a medical term that refers to fabricating or exaggerating the symptoms of mental or physical disorders for a variety of "secondary gain" motives, which may include financial compensation (often tied to fraud); avoiding school, work or military service; obtaining drugs; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder.[1] Failure to detect actual cases of malingering imposes a substantial economic burden on the health care system, and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population.[2][3]
History
In the Hebrew Bible, David feigns insanity to escape from a king who views him as an enemy.[4] Odysseus was stated to have also feigned insanity in order to avoid participating in the Trojan War.[5] Malingering has been recorded historically as early as Roman times by the physician Galen, who reported two cases. One patient simulated colic to avoid a public meeting, while the other feigned an injured knee to avoid accompanying his master on a long journey.[6] In his social-climbing manual, Elizabethan George Puttenham recommends that would-be courtiers have "sickness in his sleeve, thereby to shake off other importunities of greater consequence" and suggests feigning a "dry dropsy [...] of some such other secret disease, as the common conversant can hardly discover, and the physician either not speedily heal, or not honestly bewray." [7]
Because malingering was widespread throughout the Soviet Union to escape sanctions or coercion, physicians were limited by the state in the number of medical dispensations they could issue.[8]
With thousands forced into manual labour, doctors were presented with four types of patient;
- those who needed medical care.[9] [10];
- those who thought they needed medical care (hypochondriacs);
- malingerers; and
- those who made direct pleas to the physician for a medical dispensation from work.
This dependence upon doctors by poor labourers altered the doctor-patient relationship to one of mutual mistrust and deception.[8]
Symptoms
Some conditions are thought to be easier to feign than others. For example, everyone has experienced pain and knows how a person in pain should appear to others.[11]
Impact on society
Malingering is an offense in the United States military.[12]
Related conditions
See also
References
- ^ R. Rogers Clinical Assessment of Malingering and Deception 3rd Edition, Guilford, 2008. ISBN 1-59385-699-7
- ^ "Malingering in the Clinical Setting" Garriga, Psychiatric Times. Vol. 24 No. 3, 2007
- ^ Shapiro, AP; Teasell, RW (1998). "Misdiagnosis of chronic pain as hysteria and malingering". Current Pain and Headache Reports. 2 (1): 19–28. doi:10.1007/s11916-998-0059-5.
{{cite journal}}: Unknown parameter|month=ignored (help) [dead link] - ^ I Sam 21:10-15
- ^ Hyginus Fabulae 95. Cf. Apollodorus Epitome 3.7.
- ^ "Galen on Malingering, Centaurs, Diabetes, and Other Subjects More or Less Related", Proceedings of the Charaka Club, X (1941), p52-55
- ^ "The Art of English Posey: a Critical Edition." George Puttenham. Ed. Frank Whigham & Wayne A. Rebhorn. (2007) 379-380.
- ^ a b Structured Strain in the Role of the Soviet Physician, Mark G. Field, 1953 The American Journal of Sociology, v.58;5;493-502
- ^ Skumin V A Borderline mental disorders in chronic diseases of the digestive system in children and adolescents. Zhurnal nevropatologii i psikhiatrii imeni SS Korsakova Moscow Russia 1952 (1991), Volume: 91, Issue: 8, Pages: 81-84 PubMed: 1661526
- ^ Skumin, VA (1982). "Непсихотические нарушения психики у больных с приобретёнными пороками сердца до и после операции (обзор)". Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova (in Russian). 82 (11): 130–5. PMID 6758444.
{{cite journal}}: Unknown parameter|trans_title=ignored (|trans-title=suggested) (help) - ^ McDermott BE, Feldman MD (2007). "Malingering in the medical setting". Psychiatr Clin North Am. 30 (4): 645–62. doi:10.1016/j.psc.2007.07.007. PMID 17938038.
- ^ Rod Powers. "Article 115 — Malingering". About.com.
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