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Related to malingering: Factitious disorder




In the context of medicine, malingering is the act of intentionally feigning or exaggerating physical or psychological symptoms for personal gain.


People may feign physical or psychological illness for any number of reasons. Faked illness can get them out of work, military duty, or criminal prosecution. It can also help them obtain financial compensation through insurance claims, lawsuits, or workers' compensation. Feigned symptoms may also be a way of getting the doctor to prescribe certain drugs.
According to the American Psychiatric Association, patients who malinger are different from people who invent symptoms for sympathy (factitious diseases). Patients who malinger clearly have something tangible to gain. People with factitious diseases appear to have a need to play the "sick" role. They may feign illness for attention or sympathy.
Malingering may take the form of complaints of chronic whiplash pain from automobile accidents. Whiplash claims are controversial. Although some people clearly do suffer from whiplash injury, others may be exaggerating the pain for insurance claims or lawsuits. Some intriguing scientific studies have shown that chronic whiplash pain after automobile accidents is almost nonexistent in Lithuania and Greece. In these countries, the legal systems do not encourage personal injury lawsuits or financial settlements. The psychological symptoms experienced by survivors of disaster (post-traumatic stress disorder) are also faked by malingerers.

Causes and symptoms

People malinger for personal gain. The symptoms may vary. Generally malingerers complain of psychological disorders such as anxiety. They may also complain of chronic pain for which objective tests such as x rays can find no physical cause. Because it is often impossible to determine who is malingering and who is not, it is impossible to know how frequently malingering occurs.


Malingering may be suspected:
  • When a patient is referred for examination by an attorney
  • When the onset of illness coincides with a large financial incentive, such as a new disability policy
  • When objective medical tests do not confirm the patient's complaints
  • When the patient does not cooperate with the diagnostic work-up or prescribed treatment
  • When the patient has antisocial attitudes and behaviors (antisocial personality).
The diagnosis of malingering is a challenge for doctors. On the one hand, the doctor does not want to overlook a treatable disease. On the other hand, he or she does not want to continue ordering tests and treatments if the symptoms are faked. Malingering is difficult to distinguish from certain legitimate personality disorders, such as factitious diseases or post-traumatic distress syndrome. In legal cases, malingering patients may be referred to a psychiatrist. Psychiatrists use certain written tests to try to determine whether the patient is faking the symptoms.


In a sense, malingering cannot be treated because the American Psychiatric Association does not recognize it as a personality disorder. Patients who are purposefully faking symptoms for gain do not want to be cured. Often, the malingering patient fails to report any improvement with treatment, and the doctor may try many treatments without success.



American Psychiatric Association. 1400 K Street NW, Washington DC 20005. (888) 357-7924.

Key terms

Antisocial personality — A personality characterized by attitudes and behaviors at odds with society's customs and moral standards, including illegal acts.
Factitious diseases — Conditions in which symptoms are deliberately manufactured by patients in order to gain attention and sympathy. Patients with factitious diseases do not fake symptoms for obvious financial gain or to evade the legal system.
Post traumatic stress disorder (PTSD) — A disorder that occurs among survivors of severe environmental stress such as a tornado, an airplane crash, or military combat. Symptoms include anxiety, insomnia, flashbacks, and nightmares. Patients with PTSD are unnecessarily vigilant; they may experience survivor guilt, and they sometimes cannot concentrate or experience joy.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.


willful, deliberate, and fraudulent feigning or exaggeration of the symptoms of illness or injury to attain a consciously desired end.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Feigning illness or disability to escape work, excite sympathy, or gain compensation.
[Fr. malingre, poor, weakly]
Farlex Partner Medical Dictionary © Farlex 2012


The wilful production of symptoms, or the fraudulent simulation of illness or exaggeration of the symptoms of a minor illness or injury, usually for specific external incentives, such as the collection of benefits or to avoid work or school.

Types of malingering
• Anticipation of collecting insurance benefits.
• Malingering with psychological underpinnings, either:
   — Endogenous (e.g., factitious dermatitis); or
   — Exogenous origin (e.g., Munchausen syndrome).
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Occupational medicine The willful production of symptoms for specific external incentives, or the fraudulant simulation of illness or exaggeration of the Sx of a minor illness or injury, usually to avoid work or school. See Factitious disease(s. ). Cf Munchausen syndrome.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


Feigning illness or inability to work resulting from an ulterior motive, such as to collect insurance benefits.
[Fr. malingre, poor, weakly]
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


A pretence to be suffering from a disease, or the simulation of signs of disease, so as to gain some supposed advantage such as avoidance of work or of presumed danger, or to obtain money by fraudulent claims for compensation. See also MUNCHAUSEN'S SYNDROME.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


Feigning illness or disability (often for the purpose of gaining compensation or avoiding duty). See optokinetic nystagmus test; tunnel vision.
Millodot: Dictionary of Optometry and Visual Science, 7th edition. © 2009 Butterworth-Heinemann


Feigning illness or disability to escape work, excite sympathy, or gain compensation.
[Fr. malingre, poor, weakly]
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
They were further allocated to the malingering simulators ( n = 19) and healthy control groups ( n = 9).
For example, the Test of Memory Malingering ("TOMM") "'is a 50-item visual recognition test' that 'consists of two learning trials and an optional retention trial, and provides two cutoff scores': (1) performance that is below chance, and (2) performance that is below established norms of scores attained by head injured and cognitively impaired patients." (47) The test functions by measuring the extent to which the examinee is able to remember whether particular visual items had been presented to him during specific learning trials.
wrote: "Malingering must be considered whenever a pre-trial
To navigate this diagnostic challenge, psychiatrists need the skills to detect malingering and the confidence to deal with it appropriately.
Malingering may be comorbid with alcohol and substance abuse, factitious disorder such as Ganser and Munchausen Syndromes, conversion disorder and especially antisocial personality disorder (13).
The present findings are in contrast to the UK sample where 22%of respondents expressed concern about test reliability and likelihood of misclassification of genuine deficits as poor effort or malingering; an issue not raised in the present sample; potentially due to the growing literature available on the valid use of such tests.
It said: "The diagnosis of malingering deemed Mr M (Deyanov) as not having a serious mental illness.
The malingering response style is not uncommon (Rogers, 2008a) and should be evaluated when there is potential for external incentive (Rogers, 2008a; Young, 2010) or the client attaches importance to the counselor's assessment (Hollender & Hirsch, 1964; Rogers, 2008a; Young, 2010).
These experts evaluated Panetti for a combined total of over 15 hours and administered a battery of tests designed to detect the likelihood of malingering. The district court authorized $9000 to pay the experts, but rejected his requests for additional funding.
Other similar conditions, most of which are not included under the heading of factitious disorders, include malingering and hypochondriasis.