Psychological assessment of malingering in psychogenic neurological disorders and non‐psychogenic neurological disorders: relationship to psychopathology levels

Background and purpose:  It remains unknown whether psychological distress causes malingering in patients with psychogenic symptoms.Methods:  We studied 26 patients with psychogenic neurological disorders on psychopathology and malingering in comparison with 26 patients with various neurological conditions and 18 matched healthy controls (HC).Results:  Psychogenic patients showed the highest levels of psychological complaints and malingering, but non‐psychogenic neurological patients also showed significantly more psychological distress and malingering compared with HC. Psychological distress was related to the degree of malingering, in both patient groups.Conclusion:  This data does not formally support a causal relationship between psychological distress and psychogenic neurological disorders, but suggests that a part of the psychological complaints is a general result of having an illness. The clinical implication of this study is that psychological distress is not sufficient for diagnosing functional complaints. Also, if a patient scores normal on a test for malingering, this does not mean that he or she is not suffering from psychogenic symptoms.