Malingering
| Malingering | |
|---|---|
| Specialty | Psychiatry, clinical psychology |
| Differential diagnosis | Factitious disorder, somatization disorder |
Malingering is the intentional fabrication, feigning, or exaggeration of physical or psychological symptoms to obtain an external benefit, such as personal gain, relief from duty or work, avoidance of arrest, acquisition of medication, or mitigation of criminal sentencing.
Although malingering is not a medical diagnosis, it may be recorded as a "focus of clinical attention" or a "reason for contact with health services". It is coded in both the ICD-10 and DSM-5. Motivations vary- for example, some homeless individuals may feign mental illness to gain hospital admission. Failure to detect malingering can have significant consequences for insurance systems, healthcare institutions, public safety, and veterans' disability programs. Malingered behaviour typically ceases once the desired external goal is achieved.
Malingering is distinct from other forms of excessive illness behaviour. In somatic symptom disorder, symptoms arise from psychological causes but are experienced as real; in factitious disorder, symptoms are intentionally produced but not for external gain. Both conditions are recognised as diagnosable mental disorders in the DSM-5. However, some clinicians question the clarity of these distinctions.
The phrase "Feigned madness" is commonly used to describe the deliberate simulation of mental illness for purposes of evasion, deception, or diverting suspicion. Historically, this strategy has also been employed- sometimes formally, as with court jesters, to grant individuals license to speak uncomfortable or socially prohibited truths.