What is Malingering? Malingering in Mental Health Analysed

Malingering can be defined as a situation where a person fabricates, feigns, or over-exaggerates physical or psychological symptoms.

This action is done with a clear benefit involved. For example, the benefit would be something like missing work, missing school, or being prescribed medicine.

Malingering is closely related, but is distinct, from the two Factitious Disorders (Imposed on Another and Imposed on Self). Moreover, malingering itself is not classed as a medical condition.

Key features of Malingering

As mentioned above, malingering is not classed as a medical condition. Instead, it is seen as a behaviour.

However, it is a behaviour which may be seen in a variety of mental health conditions. For example, Antisocial Personality Disorder,

Those that are malingering do so in order to get a benefit. This is normally something tangible – like financial compensation or missing work.

Once a person has got what they want, their symptoms will stop. They will then no longer need to exaggerate their symptoms, as they have their desired outcome.

Malingering can be very difficult to detect for doctors. It will often be a fine line between genuine cases and those trying to deceive.

Doctors will typically look for symptoms that don’t match typical patterns and may look to identify a hidden reason for their actions.

But there are ethical dilemmas involved in malingering. This intersects with legal considerations too. There is a lot involved!

As discussed, there is a degree of overlap between malingering and the two Factitious Disorders. We have an article that you can read that looks into the differences between them.

Examples

Here are two examples of malingering:

• An employee has an important presentation that they need to do. But they hate presentations and do not wish to do it. They decide to call in sick to work – so that they don’t need to do the presentation. Their motive is to avoid the presentation.
• A person visits their doctor to say they have a bad back. They say that regular painkillers like Paracetamol do not work. Their back is fine, but their end goal is to be prescribed an opioid. So in the appointment they act like they can barely walk and complain of not being able to do anything. Their motive is to obtain opioid medicines.

In the above cases, it would be expected for once the presentation has been and gone, and the opioids have been secured, that their symptoms will ‘magically’ stop.

Odysseus…

Legend has it that Odysseus – the Greek hero that was the King of Ithaca – feigned illness in order to avoid the Trojan War.

Many people down the years, however famous, have engaged in malingering. Even Odysseus!

Summary

Malingering is definitely an important area. While it isn’t a mental health condition, it can play a role in various conditions.

Stopping malingering is very difficult. Unfortunately, it is something that is likely to always be present.

See Also

• Somatic Disorders: Everything You Need To Know
• Gypsy Rose and Dee Dee Blanchard: A Match Made in Hell
• What Causes Factitious Disorder Imposed on Self (Munchausen’s Syndrome)?
• What Are The Differences Between Malingering and Factitious Disorder?