Malingering in the Medical Setting

Malingering of mental illness has been studied extensively; however, malingered medical illness has been examined much less avidly. While in theory any ailment can be fabricated or self-induced, pain—including lower back pain, cervical pain, and fibromyalgia-and cognitive deficits associated with mild head trauma or toxic exposure are feigned most frequently, especially in situations where there are financial incentives to malinger. Structured assessments have been developed to help detect both types of malingering; however, in daily practice, the physician should generally suspect malingering when there are tangible incentives and when reported symptoms do not match the physical examination or no organic basis for the physical complaints is found.