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Employing Transcranial Magnetic Stimulation in a Resource Limited Environment to Establish Brain-Behavior Relationships

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Malingering in the medical setting.

Barbara E McDermott¹, Marc D Feldman

¹University of California, Davis School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Psychiatry and the Law, 2230 Stockton Blvd, 2nd Floor, Sacramento, CA 95817, USA. bemcdermott@ucdavis.edu

The Psychiatric Clinics of North America

|October 17, 2007

Summary

Malingering of medical conditions, particularly pain and cognitive deficits, is less studied than mental illness malingering. Physicians should suspect malingering when incentives exist and symptoms lack physical evidence.

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Area of Science:

Medical diagnosis
Forensic psychology
Behavioral medicine

Background:

Malingering of mental illness is well-researched.
Malingered medical illness, including pain and cognitive deficits, is less studied.
Financial incentives often drive malingering.

Purpose of the Study:

To highlight the under-researched area of medical malingering.
To identify common presentations of malingered medical illness.
To provide guidance for physicians in detecting malingering.

Main Methods:

Review of existing literature on malingering.
Analysis of common feigned medical conditions.
Discussion of diagnostic challenges and strategies.

Main Results:

Pain conditions (e.g., lower back pain, fibromyalgia) and cognitive deficits are frequently feigned.
Tangible incentives are a key indicator for suspecting malingering.
Discrepancies between reported symptoms and physical examination findings are crucial.

Conclusions:

Physicians should consider malingering when financial incentives are present and symptoms are inconsistent with objective findings.
Further research is needed to develop and validate structured assessments for medical malingering.
Early detection of malingering is essential for appropriate patient management and resource allocation.