Psychiatrists providing emergency services at an urban general hospita
l completed questionnaires on 227 patients evaluated over a two-month
period to assess whether they suspected the patient of malingering or
of having secondary gains, and whether the patient was confronted abou
t the suspicions, Thirteen percent of patients were strongly or defini
tely suspected of feigning symptoms; none received a primary diagnosis
of malingering, and less than half were confronted, Suspected seconda
ry gains included food and shelter, medications, financial gains, and
avoidance of jail, work, or family responsibilities.