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The Nuances of Determining Malingering or a Somatic Disorder  

Generally speaking, malingering and somatic disorders showcase many of the same symptoms and treatment challenges. Because of this, differentiating between the two types of disorders can become difficult for medical professionals without the appropriate experience. As diagnosis becomes more difficult, treatment becomes harder as well.

Patient self reporting is not reliable in the case of the malingering or somatic disorder. Traditional treatment often does not address the underlying cause of the symptoms that are reported. Mental health providers find it very difficult to manage these patients, and physicians without psychiatric experience sometimes prefer to completely ignore or avoid the undertaking. This is why psychiatry and other services of mental health are becoming increasingly important in consultation roles to doctors of other specialties.

The Malingering Disorder

Disorders that are defined as malingering are not mental. Nor should it be considered simple non-adherence to medical treatment. Malingering disorders should be defined as an intentional reporting of false positives or exaggerated symptoms that are motivated externally. In many cases, malingering disorders are reported for financial or legal reasons.

However, doubt as to the veracity of the patient report is not enough to diagnose a condition as malingering. Any patient attempts to obstruct a proper evaluation is also insufficient to diagnose a malingering symptom. In order for diagnosis to fit the description of malingering, symptoms must be faked or exaggerated, the production of the symptoms must be fully intentional, and there must be an external incentive for the production of the symptoms.

The Somatic Disorder

Since the publication of DSM-5, somatoform disorders have been differentiated from malingering disorders more effectively. Patients with somatic disorders may report overbearing concerns or daily life disruptions, but the symptoms are not false or intentionally exaggerated. People with somatic disorders truly believe that their symptoms are real, and they do not have the professional insight that would allow them to connect the appropriate cause to those symptoms.

Determining the Difference Between Malingering and Somatic Disorders

Psychiatric providers are the professionals with the ability to best determine if symptoms are exaggerated or feigned, as in the case of malingering disorders. At the same time, they are also the best to determine if symptoms have simply been misappropriated away from their actual causes, as in the case of somatic disorders.

Having the right consultant with this knowledge is essential to the performance of treatment programs from other medical professionals. It is also essential if a certain medical diagnosis overlaps with a legal concern. Medical and legal professionals are both well advised to seek out the expertise of clinical neuropsychologists, psychologists or psychiatrists for additional information in diagnoses that have proven to be challenging in this way.