Malingering in Inpatient Psychiatric Units

Who, When, What, and How To Address It?

Austin, Curtis MD
Shankar, Chandrika MD
Dinwiddie, Stephen H. MD

From the Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Disclosure: The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Curtis Austin, MD, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 1000, Chicago, IL 60611; email: [email protected].

Psychiatric Annals 55(5):p e116-e120, May 01, 2025. | DOI: 10.3928/00485713-20250320-01

Encounters with individuals who feign symptoms in the inpatient psychiatric setting is not uncommon but remains an underreported and under-researched phenomenon, adding to the challenges clinicians face in identifying patients who are deceitful. Patients are known to overreport and at times underreport symptoms, for numerous reasons that further complicate care, impact safety, and exacerbate scarcity of resources. With further training in reviewing clinical observations and health care records and collaborating with interdisciplinary teams, psychiatrists may be more comfortable identifying traits associated with misreporting symptoms. Ultimately, ethical practice requires psychiatrists to address suspected feigning through empathic conversations and appropriate discharge planning, to ensure that patient care is compassionate, timely, and appropriate. [Psychiatr Ann. 2025;55(5):e116–e120.]