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

Figures & data

Figure 1. Suspicion of simulation across diagnostic groups.

Table 1. Demographics of the patients.

	N (%)
Sex:
Male	185 (51)
Female	154 (43)
Missing	22 (6)
Total	362 (100)
Age: Mean (SD)	38 (16.4)
Diagnostic distribution
Missing	69 (19)
No psychiatric diagnosis	30 (8)
Substance use disorder	39 (11)
Non-affective psychosis and schizotypal disorder	86 (24)
Affective disorders	38 (10)
Anxiety and stress related disorders	41 (11)
Personality disorder	25 (7)
Multiple diagnoses	16 (4)
Other*	18 (5)

*Other includes organic disorders, mental retardation, autism spectrum disorders and ADHD.

Table 2. Responder’s position.

	N (%)
Missing	5 (1)
Graduate student	117 (33)
Junior physician	215 (59)
Psychiatrist	25 (7)

Note that the same responder was able to answer multiple questionaries if she or he had seen several patients.

Table 3. Symptoms and reasons for suspected malingering and exaggeration.

	Sample	Missing diagnosis	No previous diagnosis	Substance use disorder	Non-affective psychosis and schizotypal disorder	Affective disorder	Anxiety. PTSD and stress related disorders	Personality disorders	Other diagnosis
N (%)	362 (100)	69 (19)	30 (8)	47 (13)	90 (25)	44 (12)	46 (13)	28 (8)	25 (7)
Symptoms suspected simulated
Suicidal ideation	33 (9)	6 (9)	0 (0)	7 (15)	4 (4)	1 (2)	1 (2)	13 (46)	2 (8)
Somatic symptoms	10 (3)	1 (1)	1 (3)	2 (4)	3 (3)	0	2 (4)	1 (4)	1 (4)
Psychotic symptoms	23 (6)	5 (7)	1 (3)	6 (12)	3 (3)	1 (2)	1 (2)	5 (18)	3 (12)
Other symptoms	36 (10)	5 (7)	4 (13)	8 (17)	12 (13)	2 (5)	4 (9)	2 (7)	1 (4)
Symptoms suspected exaggerated
Suicidal ideation	29 (8)	3 (4)	1 (3)	5 (11)	6 (7)	0 (0)	3 (7)	10 (36)	2 (8)
Somatic symptoms	13 (4)	0 (0)	0 (0)	6 (13)	3 (3)	2 (5)	2 (4)	2 (7)	1 (4)
Psychotic symptoms	15 (4)	2 (3)	0 (0)	5 (11)	6 (7)	1 (2)	0 (0)	1 (4)	2 (8)
Other symptoms	21 (6)	4 (6)	1 (3)	4 (9)	5 (6)	1 (2)	2 (4)	4 (14)	1 (4)
Suspected reasons for simulation
Food/shelter	22 (6)	3 (4)	1 (3)	4 (9)	8 (9)	2 (5)	0 (0)	3 (11)	2 (8)
Drug seeking Behaviour	18 (5)	1 (1)	1 (3)	8 (17)	1 (1)	0 (0)	1 (2)	6 (21)	2 (8)
Attention seeking	33 (9)	4 (6)	2 (7)	4 (9)	2 (2)	2 (5)	5 (11)	14 (50)	2 (8)
Loneliness	21 (6)	4 (6)	2 (7)	7 (15)	3 (3)	1 (2)	1 (2)	2 (7)	1 (4)
Other*	18 (5)	4 (6)	1 (3)	6 (13)	2 (2)	1 (2)	0 (0)	4 (14)	1 (4)
Suspected reasons for exaggeration
Food/shelter	19 (5)	2 (3)	1 (3)	5 (11)	7 (8)	2 (5)	0 (0)	2 (7)	1 (4)
Drug seeking behaviour	18 (5)	0 (0)	1 (3)	8 (17)	3 (3)	1 (2)	1 (2)	4 (14)	2 (8)
Attention seeking	32 (9)	5 (7)	1 (3)	6 (13)	2 (2)	4 (9)	4 (9)	11 (40)	2 (8)
Loneliness	17 (5)	3 (4)	2 (7)	5 (11)	1 (1)	2 (5)	2 (4)	1 (4)	1 (4)
Other	18 (5)	1 (1)	0 (0)	6 (13)	5 (6)	1 (2)	0 (0)	4 (14)	2 (8)

*The ‘other’ group included various reasons for malingering with no specific recurring themes. For example, a doctor assumed that a patient wanted to be admitted to the hospital to meet a friend who was already there. Another doctor thought that a patient was malingering simply because the patient in question had a diagnosis of borderline personality disorder.

Data availability statement

Not available for this study.