Department of Psychiatry, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India.
Asian J Psychiatr. 2020 Apr;50:101952. doi: 10.1016/j.ajp.2020.101952. Epub 2020 Feb 14.
Since time immemorial, humans have tried to feign physical and mental illnesses for various reasons. This led to the development of the concept of illness deception or malingering when one tries to assume a sick role and feigns signs and symptoms to gain external incentives. The conceptual framework of malingering has undergone several changes and there is sufficient evidence to demonstrate that malingering exists. However, the diagnosis of malingering has not yet been established in the mainstream psychiatric nosological systems and still it is present in the appendices as an additional area requiring attention. This is due to the poor construct validity of the diagnosis, problems in defining malingering, problems in assessment by psychological tests and clinical assessment methodology, no well-established guidelines to detect malingering and issues related to labelling/reporting malingering. Because of several controversies in multiple domains of assessment and ethical-social issues, malingering as a distinct entity is grossly neglected. In the upcoming arena of law suits and consumer benefits suits, it is extremely important to have a better understanding of the conceptual issues related to malingering and the controversies related to it. In this review, a brief overview of evolution of concepts and controversies related to malingering is described.
自古以来，人们出于各种原因试图假装身体和精神疾病。当一个人试图扮演一个病人的角色并假装出现症状和体征以获得外部激励时，就会出现这种试图假装身体和精神疾病的行为，这导致了疾病欺骗或装病概念的发展。装病的概念框架已经经历了几次变化，有充分的证据表明装病确实存在。然而，在主流精神病学分类系统中，装病的诊断尚未确立，它仍然作为需要关注的附加领域出现在附录中。这是由于该诊断的结构效度较差、装病的定义问题、心理测试和临床评估方法评估中的问题、没有完善的检测装病的指导方针以及与装病的标记/报告相关的问题所致。由于评估的多个领域存在争议以及伦理和社会问题，作为一个独特实体的装病被严重忽视。在即将到来的诉讼和消费者福利诉讼领域，更好地了解与装病相关的概念问题以及与之相关的争议极其重要。在这篇综述中，简要描述了与装病相关的概念和争议的演变。
