Boberg Mateo, Jeppesen Ulrik, Arnfred Sidse, Nordgaard Julie
Mental Health Centre Glostrup, Nordstjernevej, Glostrup, Copenhagen, Denmark.
Mental Health Centre Amager, Gl Kongevej, Copenhagen, Denmark.
Nord J Psychiatry. 2023 Apr;77(3):234-239. doi: 10.1080/08039488.2022.2083676. Epub 2022 Jun 17.
Malingering can be divided into simulation and exaggeration of symptoms. Malingering has traditionally been considered rare in general psychiatry. In contrast to earlier estimates, more recent studies report that doctors suspect malingering frequently in psychiatric emergency departments. The aim of this study is to survey how often doctors in psychiatric emergency units in a public, free-of-charge, mental health service suspect that patients are malingering, and which diagnoses, symptom complaints and suspected reasons for malingering doctors ascribe to their patients.
Questionnaires were distributed in three psychiatric emergency departments in Denmark. Suspected simulation and exaggeration were rated with a 5-point scale. Doctors were encouraged to write down the symptoms and perceived causes for suspected malingering.
362 questionnaires were filled in. 25% of all patients were suspected of simulating to some degree. 8% of patients were highly suspected or definitely believed to be simulating. Patients complaining of suicidal ideation were most frequently suspected of malingering. '' was the most common suspected reason for malingering. Patients with diagnoses of substance use and personality disorder were the most suspected of malingering.
This is the first study to investigate doctors' suspicions of psychiatric malingering in a European setting. Patients with established personality and substance use disorder are at higher risk of being suspected of malingering, which potentially affects the course of treatment significantly. The rise in suspected malingering is conspicuous and requires further investigation. Doctors are encouraged to act conservatively upon suspicion of malingering in emergency psychiatry.
诈病可分为症状伪装和症状夸大。在传统的普通精神病学中，诈病一直被认为较为罕见。与早期估计相反，最近的研究报告称，医生在精神科急诊室经常怀疑存在诈病情况。本研究的目的是调查在一家公立免费心理健康服务机构的精神科急诊室中，医生怀疑患者诈病的频率，以及医生将哪些诊断、症状主诉和诈病的可疑原因归因于他们的患者。
在丹麦的三个精神科急诊室发放问卷。对可疑的伪装和夸大症状用5分制进行评分。鼓励医生写下可疑诈病的症状和感知到的原因。
共填写了362份问卷。所有患者中有25%被怀疑在某种程度上存在伪装。8%的患者被高度怀疑或确定被认为在伪装。抱怨有自杀念头的患者最常被怀疑诈病。“ ”是最常见的可疑诈病原因。被诊断为物质使用障碍和人格障碍的患者最常被怀疑诈病。
这是第一项在欧洲背景下调查医生对精神科诈病怀疑情况的研究。已确诊人格障碍和物质使用障碍的患者被怀疑诈病的风险更高，这可能会对治疗过程产生重大影响。可疑诈病情况的增加很明显，需要进一步调查。鼓励医生在急诊精神病学中怀疑存在诈病时采取保守行动。
