Course and prognosis

Malingerers are so heterogeneous that it is impossible to state prognosis in general. There are few adequate follow-up studies.

In forensic and inpatient settings, malingering is usually episodic, associated with particular circumstances such as impending discharge, trial, or change in conditions of imprisonment (e.g. transfer to a single cell or hospital wing). The behaviour often stops when the circumstances no longer obtain, although may recur. Similar situations occur in persons facing conscription, or in migrants at risk of repatriation.

The prognosis of malingering in personal injury litigants is unknown. Studies indicating poor outcome of many compensated litigants cannot be extrapolated, as the numbers of malingerers in these samples is unknown. Clinical experience suggests that patients with long-standing disability, even if partly or wholly non-organic, often fail to recover fully in any event.

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