October 30th 2015
Reporting of symptoms that are beyond available medical evidence is a central feature of malingering and related conditions, making the clinical differentiation of these disorders a challenge.
August 21st 2012
Quiz on Vicarious Trauma, Working With Other Physicians, and More
January 19th 2011Should malingering be considered more likely than factitious disorder when a patient exhibits pseudologia fantastica? What condition persists for longer than 3 months, accompanies a disease process, and is associated with a bodily injury that has not resolved over time? These questions and more in this interactive quiz.
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The Case of Factitious Disorder Versus Malingering
October 30th 2009Patients who exaggerate, feign, or induce physical illness are a great challenge to their physicians. Trained to trust their patients’ self-reports, even competent and conscientious physicians can fall victim to these deceptions.
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Readers React to “Abortion Trauma Syndrome”
October 27th 2009Respecting the article “Abortion Trauma Syndrome” by Arline Kaplan, I would note the irony of the claim that this syndrome is “conceived by anti-abortion activists to advance their cause,” given the obvious pro-abortion attitude of everyone associated with Kaplan’s article.
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Because numerous diseases- infectious, endocrinological, metabolic, and neurological, as well as connective-tissue disease-can induce psychiatric and/or behavioral symptoms, clinicians need to distinguish these neuropsychiatric masquerades from primary psychiatric disorders, warned José Maldonado, MD, the director of Stanford University’s Psychosomatic Medicine Service.
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Pathological Lying: Symptom or Disease?
June 1st 2008Mr A was desperate. He was about to lose yet another job, not because he was at risk for being fired, but because his lying behavior had finally boxed him into a corner. He had lied repeatedly to his colleagues, telling them that he had an incurable disease and was receiving palliative treatment. . .
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The Joker and the Thief: Persistent Malingering as a Specific Type of Therapeutic Impasse
May 1st 2007"There must be some way out of here," said the joker to the thief."There's too much confusion, I can't get no relief. . . .""No reason to get excited," the thief, he kindly spoke,"There are many here among us who feel that life is but a joke.But you and I, we've been through that, and this is not our fate,So let us not talk falsely now, the hour is getting late."From "All Along the Watchtower," Bob Dylan
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Clinical Pearls on Best Approaches to Psychogenic Movement Disorders
April 1st 2007Five words that are guaranteed to annoy your patientwith a diagnosis of psychogenic movementdisorder (PMD) are It's all in your head.It's the worst thing you can say, said Katie Kompoliti,MD, associate professor of neurological sciencesat Rush University Medical Center in Chicago.
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CRPS Type I and Mental Illness
December 1st 2006Dr Steven King provided an interesting summary of complex regional pain syndrome (CRPS) in Psychiatric Times (Complex Regional Pain Syndrome, June 2006, page 9). We felt it would be useful to provide some additional observations on the relationship between CRPS type I and psychological causes of pain.
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Neurotechnology's New Wave, Part II: Value, Acceptance, and Clinical Applications
June 18th 2006Neurotechnologic devices are proving themselves in clinical medicine. Many of these devices offer several distinct advantages over traditional pharmaceutical-based therapies: their effects are reversible, they are often cheaper than pharmaceuticals, and they solve therapy adherence issues. "If a problem occurs, you can turn off the device; or if the disease evolves over time, you can dynamically adjust the device," explained Ali R. Rezai, MD, chairman of the Center for Neurological Restoration at the Cleveland Clinic.
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The Diagnosis of Psychogenic Nonepileptic Seizures
April 1st 2006About 25% of patients seen in epilepsy clinics and monitoring units who do not respond to antiepileptic drugs (AEDs) have received a misdiagnosis.1-3 The eventual diagnosis for most of these patients will be psychogenic nonepileptic seizure (PNES)1,4-a somatoform conversion disorder. It is treatable, but diagnosis, delivery of the diagnosis, and management present significant challenges. A major barrier to care has been the stigma associated with the label "psychogenic."
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Clinical Reflections: Making Difficult Choices
April 1st 2001Psychiatrists can play a vital role in determining whether or not a patient will be a good candidate for an organ transplant. Using a case vignette, Dr. Garton explains how she helps a transplant team make the best possible decision.
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