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Racial and Gender Disparities in Diagnosis of Malingering in Clinical Settings.
J Racial Ethn Health Disparities. 2020 12; 7(6):1117-1123.JR

Abstract

PURPOSE

A malingering diagnosis can have consequences for patient care in the emergency room, hospital, and outpatient settings. Use of this diagnosis along racial and gender demographics has not been explored in clinical settings.

OBJECTIVE

To determine any differences in socio-demographic characteristics among patients diagnosed with malingering in non-psychiatric inpatient hospitals and emergency departments in the USA.

METHODS

The National Inpatient Sample (NIS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) databases were utilized to identify a malingering diagnosis from 2003 to 2015. Racial, ethnic, and gender disparities were examined.

RESULTS

The malingering diagnosis is prevalent in 0.1% of both settings. The diagnosis is more prevalent in men than women. Among inpatients, malingering diagnosis was twice as prevalent among blacks compared with whites. The adjusted OR showed similar likelihood among blacks and whites with Hispanic men having the lowest likelihood for the diagnosis. Black women were slightly more likely, while Hispanic women were less likely to be diagnosed than white women. In ED settings, whites had the highest prevalence and a higher adjusted OR for malingering diagnosis compared with other races. There was no gender difference.

CONCLUSION

The racial demographics of malingering diagnosis differ between clinical settings. Blacks may have a higher risk to receive the diagnosis as inpatients, whereas whites may have a higher risk in EDs. Hispanics have the lowest likelihood of the diagnosis in both settings. This data suggests a complex, multi-layered phenomenon highlighting how patients are diagnosed with malingering.

Authors+Show Affiliations

Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA. sadec@bcm.edu. Menninger Department of Psychiatry and Behavioral Health, Baylor College of Medicine, 1977 Butler Boulevard, 4th Floor, Houston, TX, 77030, USA. sadec@bcm.edu.Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA.Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

32152834

Citation

Udoetuk, Sade, et al. "Racial and Gender Disparities in Diagnosis of Malingering in Clinical Settings." Journal of Racial and Ethnic Health Disparities, vol. 7, no. 6, 2020, pp. 1117-1123.
Udoetuk S, Dongarwar D, Salihu HM. Racial and Gender Disparities in Diagnosis of Malingering in Clinical Settings. J Racial Ethn Health Disparities. 2020;7(6):1117-1123.
Udoetuk, S., Dongarwar, D., & Salihu, H. M. (2020). Racial and Gender Disparities in Diagnosis of Malingering in Clinical Settings. Journal of Racial and Ethnic Health Disparities, 7(6), 1117-1123. https://doi.org/10.1007/s40615-020-00734-6
Udoetuk S, Dongarwar D, Salihu HM. Racial and Gender Disparities in Diagnosis of Malingering in Clinical Settings. J Racial Ethn Health Disparities. 2020;7(6):1117-1123. PubMed PMID: 32152834.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial and Gender Disparities in Diagnosis of Malingering in Clinical Settings. AU - Udoetuk,Sade, AU - Dongarwar,Deepa, AU - Salihu,Hamisu M, Y1 - 2020/03/09/ PY - 2019/10/17/received PY - 2020/02/23/accepted PY - 2020/02/20/revised PY - 2020/3/11/pubmed PY - 2020/3/11/medline PY - 2020/3/11/entrez KW - Gender disparities KW - Malingering KW - Malingering diagnosis KW - Malingering in clinical settings KW - Racial disparities SP - 1117 EP - 1123 JF - Journal of racial and ethnic health disparities JO - J Racial Ethn Health Disparities VL - 7 IS - 6 N2 - PURPOSE: A malingering diagnosis can have consequences for patient care in the emergency room, hospital, and outpatient settings. Use of this diagnosis along racial and gender demographics has not been explored in clinical settings. OBJECTIVE: To determine any differences in socio-demographic characteristics among patients diagnosed with malingering in non-psychiatric inpatient hospitals and emergency departments in the USA. METHODS: The National Inpatient Sample (NIS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) databases were utilized to identify a malingering diagnosis from 2003 to 2015. Racial, ethnic, and gender disparities were examined. RESULTS: The malingering diagnosis is prevalent in 0.1% of both settings. The diagnosis is more prevalent in men than women. Among inpatients, malingering diagnosis was twice as prevalent among blacks compared with whites. The adjusted OR showed similar likelihood among blacks and whites with Hispanic men having the lowest likelihood for the diagnosis. Black women were slightly more likely, while Hispanic women were less likely to be diagnosed than white women. In ED settings, whites had the highest prevalence and a higher adjusted OR for malingering diagnosis compared with other races. There was no gender difference. CONCLUSION: The racial demographics of malingering diagnosis differ between clinical settings. Blacks may have a higher risk to receive the diagnosis as inpatients, whereas whites may have a higher risk in EDs. Hispanics have the lowest likelihood of the diagnosis in both settings. This data suggests a complex, multi-layered phenomenon highlighting how patients are diagnosed with malingering. SN - 2196-8837 UR - https://www.unboundmedicine.com/medline/citation/32152834/Racial_and_Gender_Disparities_in_Diagnosis_of_Malingering_in_Clinical_Settings. DB - PRIME DP - Unbound Medicine ER -
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