TY - JOUR

T1 - Do we know the mind of others? Suspicion of malingering in emergency psychiatry

AU - Boberg, Mateo

AU - Jeppesen, Ulrik

AU - Arnfred, Sidse

AU - Nordgaard, Julie

PY - 2023

Y1 - 2023

N2 - IntroductionMalingering can be divided into simulation and exaggeration of symptoms. Malingering has traditionally been considered rare in general psychiatry. In contrast to earlier estimates, more recent studies report that doctors suspect malingering frequently in psychiatric emergency departments. The aim of this study is to survey how often doctors in psychiatric emergency units in a public, free-of-charge, mental health service suspect that patients are malingering, and which diagnoses, symptom complaints and suspected reasons for malingering doctors ascribe to their patients.MethodsQuestionnaires were distributed in three psychiatric emergency departments in Denmark. Suspected simulation and exaggeration were rated with a 5-point scale. Doctors were encouraged to write down the symptoms and perceived causes for suspected malingering.Results362 questionnaires were filled in. 25% of all patients were suspected of simulating to some degree. 8% of patients were highly suspected or definitely believed to be simulating. Patients complaining of suicidal ideation were most frequently suspected of malingering. ‘Attention seeking’ was the most common suspected reason for malingering. Patients with diagnoses of substance use and personality disorder were the most suspected of malingering.ConclusionThis is the first study to investigate doctors’ suspicions of psychiatric malingering in a European setting. Patients with established personality and substance use disorder are at higher risk of being suspected of malingering, which potentially affects the course of treatment significantly. The rise in suspected malingering is conspicuous and requires further investigation. Doctors are encouraged to act conservatively upon suspicion of malingering in emergency psychiatry.

AB - IntroductionMalingering can be divided into simulation and exaggeration of symptoms. Malingering has traditionally been considered rare in general psychiatry. In contrast to earlier estimates, more recent studies report that doctors suspect malingering frequently in psychiatric emergency departments. The aim of this study is to survey how often doctors in psychiatric emergency units in a public, free-of-charge, mental health service suspect that patients are malingering, and which diagnoses, symptom complaints and suspected reasons for malingering doctors ascribe to their patients.MethodsQuestionnaires were distributed in three psychiatric emergency departments in Denmark. Suspected simulation and exaggeration were rated with a 5-point scale. Doctors were encouraged to write down the symptoms and perceived causes for suspected malingering.Results362 questionnaires were filled in. 25% of all patients were suspected of simulating to some degree. 8% of patients were highly suspected or definitely believed to be simulating. Patients complaining of suicidal ideation were most frequently suspected of malingering. ‘Attention seeking’ was the most common suspected reason for malingering. Patients with diagnoses of substance use and personality disorder were the most suspected of malingering.ConclusionThis is the first study to investigate doctors’ suspicions of psychiatric malingering in a European setting. Patients with established personality and substance use disorder are at higher risk of being suspected of malingering, which potentially affects the course of treatment significantly. The rise in suspected malingering is conspicuous and requires further investigation. Doctors are encouraged to act conservatively upon suspicion of malingering in emergency psychiatry.

U2 - 10.1080/08039488.2022.2083676

DO - 10.1080/08039488.2022.2083676

M3 - Journal article

C2 - 35714972

VL - 77

SP - 234

EP - 239

JO - Nordisk Psykiatrisk Tidsskrift

JF - Nordisk Psykiatrisk Tidsskrift

SN - 0803-9496

IS - 3

ER -