Malingering

Both physical and/or psychological malingering

Malingering Definition: The deliberate exaggeration of psychological and/or physical complaints for purposes of tangible gain (Eg. monetary rewards, etc) is referred to as malingering. The use of the health care system and its resources are severely impacted by patients who malinger. Access to clinicians by patients with valid concerns can be obstructed as well as costs escalated by needless tests for falsified symptoms.

Presentation: Malingering can be expressed in several forms from pure malingering in which the individual falsifies all symptoms to partial malingering in which the individual has symptoms but exaggerates the impact which they have upon daily functioning. Another form of malingering is simulation in which the person emulates symptoms of a specific disability or dissimulation when the patient denies the existence of problems which would account for the symptoms (Eg. drug abuse, etc). Another form of malingering is false imputation in which the individual has valid symptoms but is dishonest as to the source of the problems, attributing them, for example, to an automobile accident when the cause was, in fact, an injury occurring in the home.

Motivation: While, as indicated, the malingering individual is seeking tangible gains such as time-off from work and/or financial gain, the underlying motivations may differ among such patients. Indeed, there may be individuals who falsify their symptoms because they believe that it is inevitable that such symptoms will arise later. For example, an individual may state that they have symptoms of infection when not present, while they can receive compensation, because they believe that they will likely develop the infection at some future point.

Concerns: The financial, time and energy commitment created by malingering individuals is an appreciable problem in health care. Whether the goal be to obtain narcotics, to obtain time off from work and/or to secure financial benefits such as disability payment, the costs to the health care delivery system have proved enormous.

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