Malingering (ma-LING-er-ing) means intentionally pretending to be sick or injured to avoid work or responsibility. The illnesses faked may be physical, such as the flu, or mental such as depression. Similarly, a person may pretend to have severe back pain due to an injury. Sometimes a person may actually have a mild illness or injury and exaggerate the symptoms.
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Why Do Some People Malinger?
Although there are rare instances in which malingering may have a positive or useful purpose, such as faking illness as a prisoner of war, it is generally considered to be unacceptable behavior. Why then do people sometimes act this way?
People may fake a disorder for many reasons. They may wish to shirk military service or jury duty or avoid going on trial for some criminal act. Some people feign illness to get extra time off from school or their job. Others may fake or exaggerate an injury or disease to get undeserved money from an insurance company. Some people may malinger to get extra attention, sympathy, or help from family or coworkers.
Telling Malingering from a Real Illness
As long as there have been malingerers, there have likely been others who understood what they were up to. The Greek physician Galen, who lived in the second century A.D. , wrote, "People for many reasons may pretend to be ill; it is desirable, then, that the physician should be able to arrive at the truth in such cases." Using their experience with actual diseases, he said, physicians need to distinguish tricks of the malingerer from the "true signs" of disease.
Physicians today face many of the same basic problems with malingering that Galen did. To tell malingering from a real illness, doctors need to perform a thorough physical examination that may include tests to find out whether or not the symptoms a person claims to have are real and are a true sign of disease or injury. Doctors also need to be aware of circumstances in their patients' lives, such as unwanted work or duties, that might cause them to fake a disorder.
* depression (de-PRESH-un) is a mental state characterized by feelings of sadness, despair, and discouragement.
* hypochondria (hy-po-KON-dree-a) is a mental disorder in which people believe that they are sick, but their symptoms are not related to any physical illness.
* conversion disorder is a mental disorder in which psychological symptoms are converted to physical symptoms, such as blindness, paralysis, or seizures. A person with conversion disorder does not intentionally produce symptoms.
* Munchausen syndrome (MOON-chow-zen SIN-drome) is a mental disorder in which a person pretends to have symptoms or causes symptoms of a disease in order to be hospitalized or receive tests, medication, or surgery,
Certain mental disorders could be confused with malingering. For example, in hypochondria * , conversion disorder * , and Munchausen * syndrome, the patients' symptoms may not arise from actual physical conditions, yet these mental disorders are not the same as malingering. When people miss work or school because of physical symptoms that occur because of stressful changes or emotional upsets in their lives, they are not considered to be malingering. Individuals who are malingering know they are not sick and intentionally pretend to be ill.