“Iatrogenic Malingering” in VA Substance Abuse Treatment

The authors share some observations from working on 2 inpatient psychiatry wards at a Veteran Affairs hospital. Because admission criteria do not permit hospitalization of patients with substance use disorders alone, patients are prompted to present with ubiquitous complaints such as depression & suicidality. The authors view these willful misrepresentations of symptoms in order to gain more comprehensive care as rational responses to changes in accessibility of psychiatry & social services to substance abusers. (3 refs)