Screening for Malingering in the Emergency Department

Zubera, Atika; Raza, Mahreen; Holaday, Eric; Aggarwal, Rashi

doi:10.1007/s40596-014-0253-1

Cited by 13 publications

(6 citation statements)

References 4 publications

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“…There have been no formal studies regarding the use of screening tools to detect malingering behaviors in the ED; however, there are two potentially useful questionnaires [15]. The Structured Interview of Reported Symptoms (SIRS) has been considered by many to be the gold standard in detecting psychiatric malingering since its publication in 1992.…”

Section: Discussionmentioning

confidence: 99%

“…However, a 2011 meta-analysis suggests the specificity may be significantly lower than initially thought, estimating that the SIRS may fail to identify as many as one in four malingerers [16]. The Miller Forensic Assessment of Symptoms Test (M-FAST) may be more promising in emergency settings as it consists of only 25 items, can typically be administered in less than 15 minutes, and has fairly simple interpretation with yes or no responses and a cut-off value to indicate psychiatric malingering [15]. However, despite its potential, there is currently insufficient data supporting the clinical validity of the M-FAST outside of forensic settings [15,17].…”

Section: Discussionmentioning

confidence: 99%

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Malingering in the Emergency Setting

Zwick

Sharp

Severn

et al. 2021

Cureus

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Malingering is the intentional fabrication of symptoms for material gain. Malingering among frequent utilizers and patients with psychiatric symptoms is suspected to be common in emergency settings but difficult to detect and manage. We present a case report of a 50-year-old man feigning psychosis and suicidality in order to obtain shelter. Strategies to identify malingered psychiatric symptoms are presented. Understanding how malingering is adaptational can help clinicians begin to manage these patients and symptoms in a compassionate manner that preserves healthcare resources, improves patient care, and reduces the risk of burnout for clinicians.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Malingering in the Emergency Setting

Zwick

Sharp

Severn

et al. 2021

Cureus

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“…Finally, there is a growing body of literature (Rumschik & Appel, 2019;Zubera, Raza, Holaday, & Aggarwal, 2015) investigating malingering in PES. Malingering is intentionally fabricating or exaggerating symptoms to obtain external benefits (American Psychiatric Association, 2013) such as hospitalization or medication, and one study reports suspicion of malingering in 33% of patients (Rumschik & Appel, 2019).…”

Section: Discussionmentioning

confidence: 99%

Professionals’ Perspective on Needs of Persons Who Frequently Use Psychiatric Emergency Services

Schmidt

Garmy

Stjernswärd

et al. 2020

Issues in Mental Health Nursing

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This study explores how professionals experience persons who frequently use psychiatric emergency services (PES) in terms of their needs in Sweden. The data comprise 19 semi-structured individual interviews and one focus group interview with healthcare professionals (i.e., assistant nurses, psychiatric nurses, intern physicians, and resident physicians), which are analyzed using qualitative content analysis. The overall findings suggest that persons who frequently use PES suffer from illness, unfavorable life circumstances, and inadequate care, which together emphasize the need for more sustainable support. The findings indicate that the professionals saw beyond illness-related needs and could also acknowledge patients' needs originating from social, existential, and care-and support-related aspects of life.

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“…Assessments were made by attending psychiatrists, who have the most experience evaluating psychopathology and medical illness and using clinical judgment to discern primary and secondary gain (16). Although psychological testing for malingering could be helpful (22), it was not used because it may be impractical in the emergency setting (23) and likely to interrupt care and diminish the response rate.…”

Section: Methodsmentioning

confidence: 99%

Malingering in the Psychiatric Emergency Department: Prevalence, Predictors, and Outcomes

Rumschik

Appel

2019

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Malingering is commonly encountered in the psychiatric emergency department, yet little is known about its prevalence, objectives, or effect on patient management. This study analyzed characteristics of malingering and patient disposition in a 24/7-staffed comprehensive psychiatric emergency program (CPEP) and created predictive models to understand malingering and its effect on physician decision making.Methods: Attending psychiatrists completed questionnaires after comprehensive assessments of 405 patients presenting to the CPEP during the 1-month study, recording suspicion of malingering, symptoms malingered, associated secondary gains, demographic characteristics, and initial disposition decision. Analyses examined characteristics associated with degree of malingering suspicion and disposition.

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Screening for Malingering in the Emergency Department

Cited by 13 publications

References 4 publications

Malingering in the Emergency Setting

Malingering in the Emergency Setting

Professionals’ Perspective on Needs of Persons Who Frequently Use Psychiatric Emergency Services

Malingering in the Psychiatric Emergency Department: Prevalence, Predictors, and Outcomes

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