Suspect malingering in patients who have attempted suicide and have an obvious
secondary gain. Perform a thorough psychosocial assessment, evaluate the patient's history through collateral sources and medical records, and carefully assess and treat comorbid psychiatric disorders.
A target is the disorder feigned for
secondary gain. For example, a litigant may fake cognitive impairment and disorientation to establish head trauma in a personal injury suit.
The authors of the current paper contend that duration of reported symptoms does not necessarily imply the
secondary gain of compensation associated with malingering.
If defense counsel cannot get your expert to admit the possibility of malingering, they may get him or her to admit the possibility of
secondary gain, particularly where the plaintiff's symptoms persevere.
Thus, investigators should consider the possibility of MSBP if they believe there to be some
secondary gain - in the form of attention or notoriety - afforded the offender at the expense of the victim.
Amazingly, most companies' bottom lines came through the refi campaign relatively unscathed, thanks only to great support from the
secondary gain and warehouse income contingents.
Factors that seemed to contribute to long-term response in this small group of patients included a report of sleeping at least half of the time while in bed, increased hypnotic susceptibility, no history of major depression, and a lack of
secondary gain.
Unfortunately, there are patients who use statements such as "I am hearing voices telling me to kill myself and others" in order to be admitted to hospitals or for
secondary gain. Getting or attempting to get details about these "voices" and documenting what we are told can be an invaluable part of a patient's records.
There would be no
secondary gain and charts would be reviewed based on actual evidence-based medicine.
Some girls learn to get
secondary gain from the problem, complaining of symptoms and asking a parent to look at the problem area, sometimes for attention and sometimes to avoid unwanted tasks.
Some of the factors that would tend to increase the risks of living unrelated kidney donation are significant psychiatric symptoms or disorders; substance abuse or dependence; a lack of health insurance; a limited capacity to understand risks; motives reflecting a desire for recognition; a subordinate relationship to the patient, such as employee or employer; or an expectation of
secondary gain.
I have more time to focus on my specialty in osteopathic manipulative medicine and discuss options for conservative nonsurgical treatment of neck and back pain now that the litigious nature of worrying about the
secondary gain of drug-seeking behavior is someone else's responsibility.
