Introduction
Mental status examination and a patient’s history are the most essential diagnostic instruments a psychiatrist has to acquire information to make precise diagnoses. Priority must be given by clinicians to ensure they have critical information such as a patient’s medical history and their mental health status. This will help in proper diagnosis and treatment suggestions when it comes to suggesting the best medication. This paper assesses the importance of collecting this information and discusses the differences between DSM5 and malingering diagnoses.
Importance of Gathering Patient Information
One importance lies in the ability to provide an accurate diagnosis. Important information like previous medical history can help clinicians understand better a patient’s symptoms and diagnosis (Jin et al., 2021). For example, depression can be a viable option if in the past a patient had suffered from symptoms like fatigue, loss of appetite, insomnia, gastrointestinal problems, and joint pain. Secondly, gathering this information would help in the assessment of various variables in terms of diseases. For example, if a patient’s history showed a pattern of malnutrition, discrimination, and rampant mood fluctuations, a clinician could conclude that this is a possible case of anxiety or depression.
Finally, it has been proven that access to critical information about a patient’s history, health, and mental status can help healthcare professionals make better decisions when preparing a care and treatment plan (Rutherford et al., 2021). If a patient has a pre-existing condition such as diabetes and is diagnosed with depression, clinicians understand how to customize the patient’s medical interventions. For example, monoamine oxidase inhibitors can result in weight gain, and tricyclic antidepressants can cause hyperglycemia. Both can be disastrous for people with diabetes. Based on this, the clinician may opt for non-TCAs such as citalopram, sertraline, and venlafaxine since TCAs increase cravings and escalate fasting blood glucose (FBG levels)
Difference Between Malingering and DSM-5 Diagnosis
According to Sadek (2022), malingering refers to the falsification or thoughtful exaggeration of physical or mental illness to acquire external benefits such as seeking drugs, avoiding work, avoiding trial, leaving school, avoiding military services, or gaining paid leave from work. Conversely, a DSM5 diagnosis criterion is for assessing whether the disorder was a pretence using pre-established and evidence-based indicators (Zucco & Sartori, 2023). Malingering and DSM5 can be differentiated using two techniques: availability of external gain and poor compliance with treatment.
Firstly, external gain is a critical distinction between malingering and DSM5. For example, the patient may create psychological or physical symptoms to assume the sick role to benefit from paid work leave. In DSM5, the patient may not be aware of the presence of psychological illness, and the criteria provide detailed examples of signs and symptoms of mental health conditions. Secondly, malingering individuals stop complaining after getting the benefit, while in DSM5, patients require continuous monitoring and evidence-based interventions, which are both pharmacologic and non-pharmacologic (Geiger et al., 2021). Invasive interventions and diagnostics are avoided in malingering individuals since their harm outweighs the benefits. For example, an individual faking depression to get access to benzodiazepines is at risk of physical dependence and may impair their cognitive functions in the long run.
Conclusion
Collecting accurate patient information is important to providing patient-centred care, correct diagnosis, and making informed decisions. Malingering is difficult to diagnose and treat due to exaggerated manifestations of the patient. Malingering disorder is best managed by an inter-professional team comprising psychiatrists, mental health nurses, and psychotherapists. DSM5 criteria play an instrumental role in assisting clinicians in diagnosing multiple psychiatric issues, such as depression, anxiety, and bipolar disorders among others.
References
Geiger, M., Bärwaldt, R., & Wilhelm, O. (2021). The Good, the Bad, and the Clever: Faking Ability as a Socio-Emotional Ability? Journal of Intelligence, 9(1), 13. https://doi.org/10.3390/jintelligence9010013
Jin, D., Pan, E., Oufattole, N., Weng, W.-H., Fang, H., & Szolovits, P. (2021). What Disease Does This Patient Have? A Large-Scale Open Domain Question Answering Dataset from Medical Exams. Applied Sciences, 11(14), 6421. https://doi.org/10.3390/app11146421
Rutherford, M., Maciver, D., Johnston, L., Prior, S., & Forsyth, K. (2021). Development of a Pathway for Multidisciplinary Neurodevelopmental Assessment and Diagnosis in Children and Young People. Children, 8(11), 1033. https://doi.org/10.3390/children8111033
Sadek, J. (2022). Malingering and Stimulant Medications Abuse, Misuse and Diversion. Brain Sciences, 12(8), 1004. https://doi.org/10.3390/brainsci12081004
Zucco, G. M., & Sartori, G. (2023). Sensory and Cognitive Malingering: Studies and Tests. Sci, 5(3), 27–27. https://doi.org/10.3390/sci5030027
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