A 40-year-old factory worker develops sudden right arm weakness on the day he receives notice of a compulsory job transfer. Neurological examination is inconsistent, investigations are normal, and he shows little concern about the deficit. He tells the resident privately that if the weakness persists he will not be transferred. What is the MOST likely diagnosis?
- A Conversion disorder (functional neurological symptom disorder)
- B Factitious disorder
- C Malingering ✓
- D Illness anxiety disorder
Correct answer: C. Malingering
Explanation
Symptoms produced consciously for a clear external incentive, here avoidance of a job transfer, define malingering. Conversion disorder involves unconscious production of deficits without secondary gain, though la belle indifference can occur in both. Factitious disorder involves conscious feigning but motivated by assuming the sick role, with no tangible external reward. Illness anxiety disorder involves fear of having illness without feigned neurological signs.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.