Jan 25, 2026
Reproducible Search Strategy - CHARACTERISTICS OF STUDIES ON THE DIAGNOSIS OF MALINGERING
- Kevin Xu1
- 1Washington University
Protocol Citation: Kevin Xu 2026. Reproducible Search Strategy - CHARACTERISTICS OF STUDIES ON THE DIAGNOSIS OF MALINGERING. protocols.io https://dx.doi.org/10.17504/protocols.io.ewov1kz4ogr2/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: January 25, 2026
Last Modified: January 25, 2026
Protocol Integer ID: 240845
Keywords: diagnosis of malingering, clinical investigation of malingering, explanatory models of malingering, malingering, malingering in defendant, characteristics of military malingering, new forms of diagnosis, clinical investigation, military malingering, diagnosis, malingering mild traumatic brain injury, reported symptom, patient, clinical setting, psychologic evaluation, ovid medline, case report, patient characteristic, forensic psychiatry practice, psychiatry research, feigned psychiatric symptom, retrospective analysis of the national inpatient sample, national inpatient sample, goal of this systematic review, mental health diagnosis, characteristics of study, search strategy, initial search strategy, exp hospital emergency, guidance on the reporting, mental health diagnoses in people, statistical manual of mental disorder, reproducible search strategy, psychopatholog, comorbid psychopathology, hospitalized patient
Abstract
The initial search strategy can be found here: dx.doi.org/10.17504/protocols.io.e6nvwdwozlmk/v1
The goal of this systematic review was to evaluate the characteristics of studies on the diagnosis of malingering. The initial search was conducted in December 2023, yielding 5,024 articles. The search was repeated in June 2025, yielding an additional 275 articles.
Search strategy:
Ovid Medline
1285 results on 12/18/2023
61 results on 6/17/25 with date limit: limit 6 to dt=20231215-20250617
Ovid MEDLINE(R) ALL <1946 to December 15, 2023>
1 exp malingering/ or Malinger*.mp. or (feign* adj4 (psychopatholog* or symptom*)).mp. or feigned.mp. or conscious-simulation.mp. or pathomimia.mp.
2 exp Emergency Medical Services/ or exp hospital emergency service/ or exp forensic psychiatry/ or emergicenter*.ti,ab. or (emergency adj3 (department* or ward* or Nurs* or physician* or medicine or accidents)).ti,ab. or ((ED or ER) adj3 (care or service* or department* or unit* or ward* or room* or center* or centre* or system* or evaluation* or assess* or visit* or Nurs* or physician* or patient* or personnel)).ti,ab. or (Clinic* or veteran* or hospital* or outpatient* or inpatient*).mp.
3 1 and 2
4 3 not (exp child/ not (exp child/ and exp adult/))
5 4 not (case reports or validation study).pt.
6 limit 5 to english language
Embase.com
2,052 results on 12/18/2023
135 results on 6/17/25 with date limit: #7 AND [17-12-2023]/sd NOT [18-06-2025]/sd
1 ‘malingering’/exp or Malinger*:ti,ab,kw,de or (feign* near/4 (psychopatholog* or symptom*)):ti,ab,kw,de or conscious-simulation:ti,ab,kw,de or pathomimia:ti,ab,kw,de
2 'emergency health service'/exp OR 'emergency ward'/exp OR 'forensic medicine'/exp or (Clinic* or veteran* or hospital* or outpatient* or inpatient*):ti,ab,kw,de OR emergicenter*:ti,ab,kw,de OR ((trauma NEAR/1 (patient* OR center* OR centre* OR department* OR unit* OR room*)):ti,ab) OR (((emergency OR emergencies) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR medicine OR visit* OR nurs* OR physician* OR clinician* OR personnel OR patient* OR accidents)):ti,ab,kw,de) OR (((ems OR ed OR er) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR patient* OR personnel)):ti,ab,kw,de) OR ((('a&e' OR 'a & e') NEAR/2 (department* OR admission* OR admitted)):ti,ab)
3 1 and 2
4 #3 NOT ('child'/exp NOT ('child'/exp AND 'adult'/exp))
6 #4 NOT ('case report'/exp OR 'validation study'/exp)
7 #5 AND [english]/lim
Web of Science
1,249 Results on 12/18/2023
70 results on 6/17/25 refined by: Publication Years: 2024 or 2025
Web of Science Core Collection:
Science Citation Index Expanded
Social Sciences Citation Index Expanded
Arts & Humanities Citation Index
Emerging Sources Citation Index
1 (TS=(Malinger* or conscious-simulation or pathomimia)) OR (TS=(feign* near/4 (psychopatholog* or symptom*)))
2 (TS= (Clinic* or veteran* or hospital* or outpatient* or inpatient* OR emergicenter*)) OR (TS=((trauma NEAR/1 (patient* OR center* OR centre* OR department* OR unit* OR room*))) ) OR (TS=(((emergency OR emergencies) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR medicine OR visit* OR nurs* OR physician* OR clinician* OR personnel OR patient* OR accidents)) )) OR (TS=((ems OR ed OR er) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR patient* OR personnel)) )
3 1 and 2
4 #3 NOT KP= ("child" NOT ("child" AND "adult"))
5 #4 NOT TS=("case report" OR "validation study")
6 #5 AND [english]/lim
APA PsycInfo
403 Results on 12/18/2023
9 results on 6/17/25 with date limit 2024-2025
1 DE "Malingering" OR (AB=(Malinger* or conscious-simulation or pathomimia)) OR (TI=(Malinger* or conscious-simulation or pathomimia))
2 (DE "Emergency Medicine" OR DE "Emergency Services" OR DE "Hospital Admission" OR DE "Hospital Discharge" OR DE "Hospitals" OR DE "Hospitalization" OR DE "Hospitalized Patients") OR SU hospital* OR SU clinic* OR SU Inpatient OR SU veteran OR (AB= (Clinic* or veteran* or hospital* or outpatient* or inpatient* OR emergicenter*)) OR (AB=((trauma NEAR/1 (patient* OR center* OR centre* OR department* OR unit* OR room*))) ) OR (AB=(((emergency OR emergencies) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR medicine OR visit* OR nurs* OR physician* OR clinician* OR personnel OR patient* OR accidents)) )) OR (AB=((ems OR ed OR er) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR patient* OR personnel)) ) OR (AB= (Clinic* or veteran* or hospital* or outpatient* or inpatient* OR emergicenter*)) OR (AB=((trauma NEAR/1 (patient* OR center* OR centre* OR department* OR unit* OR room*))) ) OR (TI=(((emergency OR emergencies) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR medicine OR visit* OR nurs* OR physician* OR clinician* OR personnel OR patient* OR accidents)) )) OR (TI=((ems OR ed OR er) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR patient* OR personnel)) )
3 1 AND 2
4 SU test-validity
5 3 NOT 4
6 5 AND Narrow by Language: - english
Proquest Dissertations and Theses Global
35 results on 12/18/23
0 results on 6/17/2025 with date limit 2023-current
noft(malinger*) AND noft(hospital* OR emergency OR discharge* OR drug-seeking)
Key references:
1. Diagnostic and Statistical Manual of Mental Disorders, 5th ed, text rev. Washington, DC, American Psychiatric Association, 2022
2. Weiss KJ, Van Dell L: Liability for diagnosing malingering. J Am Acad Psychiatry Law 2017; 45:339–347
3. Park L, Costello S, Li JJ, et al: Race, health, and socioeconomic disparities associated with malingering in psychiatric patients at an urban emergency department. Gen Hosp Psychiatry 2021; 71:121–127
4. Barry R, Anderson J, Tran L, et al: Prevalence of mental health disorders among individuals experiencing homelessness: a systematic review and meta-analysis. JAMA Psychiatry 2024; 81:691–699
5. Xu KY, Gabrielian SE, Brown TR: Mental health diagnoses in people experiencing homelessness. JAMA Psychiatry 2024; 81:1047
6. Punko D, Luccarelli J, Bains A, et al: The diagnosis of malingering in general hospitals in the United States: a retrospective analysis of the National Inpatient Sample. Gen Hosp Psychiatry 2023; 85:133–138
7. Rumschik SM, Appel JM: Malingering in the psychiatric emergency department: prevalence, predictors, and outcomes. Psychiatr Serv 2019; 70:115–122
8. Hansen H, Bourgois P, Drucker E: Pathologizing poverty: new forms of diagnosis, disability, and structural stigma under welfare reform. Soc Sci Med 2014; 103:76–83
9. Alter HJ, Dalawari P, Doran KM, et al: Chapters on homelessness and substance use; in Social Emergency Medicine: Principles and Practice. Cham, Switzerland, Springer, 2021
10. Fadus MC, Odunsi OT, Squeglia LM: Race, ethnicity, and culture in the medical record: implicit bias or patient advocacy? Acad Psychiatry 2019; 43:532–536
11. Higgins JPT, Morgan RL, Rooney AA, et al: A tool to assess risk of bias in non-randomized follow-up studies of exposure effects (ROBINS-E). Environ Int 2024; 186:108602
12. Flanagin A, Frey T, Christiansen SL: Updated guidance on the reporting of race and ethnicity in medical and science journals. JAMA 2021; 326:621–627
13. Borrell LN, Elhawary JR, Fuentes-Afflick E, et al: Race and genetic ancestry in medicine—a time for reckoning with racism. N Engl J Med 2021; 384:474–480
14. Bailey ZD, Krieger N, Agénor M, et al: Structural racism and health inequities in the USA: evidence and interventions. Lancet 2017; 389:1453–1463
15. Cabeldue M, Green D, McGrath RE, et al: Factors related to repeat forensic hospital admissions for restoration of competency to stand trial. J Forensic Psychol Res Pract 2021; 21:91–117 CrossRef
16. Costopoulos JS: Aggression in an inpatient psychiatric facility: a retrospective longitudinal study. J Forensic Psychol Res Pract 2019; 19:242–259 CrossRef
17. Bhalla IP, Siegel K, Chaudhry M, et al: Involuntary psychiatric hospitalization: how patient characteristics affect decision-making. Psychiatr Q 2022; 93:297–310
18. Gacono CB, Meloy JR, Sheppard K, et al: A clinical investigation of malingering and psychopathy in hospitalized insanity acquittees. Bull Am Acad Psychiatry Law 1995; 23:387–397
19. Greve KW, Ord JS, Bianchini KJ, et al: Prevalence of malingering in patients with chronic pain referred for psychologic evaluation in a medico-legal context. Arch Phys Med Rehabil 2009; 90:1117–1126
20. Jennings JL, Rice K, Baglio C: Jail-based competency treatment comes of age: multi-site outcomes and challenges to the implementation of an evidence-based forensic continuum. Behav Sci Law 2021; 39:83–105
21. McDermott BE, Dualan IV, Scott CL: Malingering in the correctional system: does incentive affect prevalence? Int J Law Psychiatry 2013; 36:287–292
22. McDermott BE, Sokolov G: Malingering in a correctional setting: the use of the Structured Interview of Reported Symptoms in a jail sample. Behav Sci Law 2009; 27:753–765
23. Nesbit-Bartsch AE, McDermott BE, Warburton KD: Gender and malingering in defendants deemed incompetent to stand trial. J Am Acad Psychiatry Law 2021; 49:211–218
24. Salinsky M, Rutecki P, Parko K, et al: Psychiatric comorbidity and traumatic brain injury attribution in patients with psychogenic nonepileptic or epileptic seizures: a multicenter study of US veterans. Epilepsia 2018; 59:1945–1953
25. Simpson SA, Loh R, Goans CRR, et al: Suicide and self-harm outcomes among psychiatric emergency service patients diagnosed as malingering. J Emerg Med 2021; 61:381–386
26. Yates BD, Nordquist CR, Schultz-Ross RA: Feigned psychiatric symptoms in the emergency room. Psychiatr Serv 1996; 47:998–1000
27. Lande RG, Williams LB: Prevalence and characteristics of military malingering. Mil Med 2013; 178:50–54
28. Udoetuk S, Dongarwar D, Salihu HM: Racial and gender disparities in diagnosis of malingering in clinical settings. J Racial Ethn Health Disparities 2020; 7:1117–1123
29. Dell NA, Carbone JT, Holzer KJ, et al: Malingering and comorbid psychopathology: evidence from the 2016–2017 Nationwide Emergency Department Sample. Gen Hosp Psychiatry 2021; 73:121–122
30. Denning JH, Shura RD: Cost of malingering mild traumatic brain injury–related cognitive deficits during compensation and pension evaluations in the Veterans Benefits Administration. Appl Neuropsychol Adult 2019; 26:1–16
31. Guarnera LA, Murrie DC, Gardner BO, et al: Are forensic evaluators more likely to conclude that Black or White defendants are malingering? Law Hum Behav 2024; 48:545–563
32. Svete LJ, Tindell WW, McLouth CJ, et al: A retrospective analysis of rates of malingering in a forensic psychiatry practice. J Am Acad Psychiatry Law (Epub Jan 30, 2025) CrossRef
33. Rogers R, Sewell KW, Goldstein AM: Explanatory models of malingering—a prototypical analysis. Law Hum Behav 1994; 18:543–552 Crossref
34. Brown TR, Xu KY, Glowinski AL: Cognitive behavioral therapy and the implementation of antiracism. JAMA Psychiatry 2021; 78:819–820
35. Bryant BE, Jordan A, Clark US: Race as a social construct in psychiatry research and practice. JAMA Psychiatry 2022; 79:93–94
36. Metzl JM, Hansen H: Structural competency: theorizing a new medical engagement with stigma and inequality. Soc Sci Med 2014; 103:126–133
37. Gabrielian S, Hellemann G, Koosis ER, et al: Do cognition and other person-level characteristics determine housing outcomes among homeless-experienced adults with serious mental illness? Psychiatr Rehabil J 2021; 44:176–185
38. Brown TR, Lee W-L, Ventimiglia J, et al: Medicaid claims from 2008 to 2016 indicate low rates of genetic testing among children with intellectual disability and autism spectrum disorder. Genet Med 2025; 27:101451
40. Baggett TP, Hwang SW, O’Connell JJ, et al: Mortality among homeless adults in Boston: shifts in causes of death over a 15-year period. JAMA Intern Med 2013; 173:189–195
41. Fine DR, Dickins KA, Adams LD, et al: Drug overdose mortality among people experiencing homelessness, 2003 to 2018. JAMA Netw Open 2022; 5:e2142676
42. Cano M, Oh S: State-level homelessness and drug overdose mortality: evidence from US panel data. Drug Alcohol Depend 2023; 250:110910
Guidelines
5 3 NOT 4
6 5 AND Narrow by Language: - english
Proquest Dissertations and Theses Global35 results on 12/18/230 results on 6/17/2025 with date limit 2023-current
noft(malinger*) AND noft(hospital* OR emergency OR discharge* OR drug-seeking)
Troubleshooting
Ovid MEDLINE(R) ALL 1946 to December 15, 2023
exp malingering/ or Malinger*.mp. or (feign* adj4 (psychopatholog* or symptom*)).mp. or feigned.mp. or conscious-simulation.mp. or pathomimia.mp.
exp Emergency Medical Services/ or exp hospital emergency service/ or exp forensic psychiatry/ or emergicenter*.ti,ab. or (emergency adj3 (department* or ward* or Nurs* or physician* or medicine or accidents)).ti,ab. or ((ED or ER) adj3 (care or service* or department* or unit* or ward* or room* or center* or centre* or system* or evaluation* or assess* or visit* or Nurs* or physician* or patient* or personnel)).ti,ab. or (Clinic* or veteran* or hospital* or outpatient* or inpatient*).mp.
1 and 2
not (exp child/ not (exp child/ and exp adult/))
not (case reports or validation study).pt.
limit 5 to english language
Embase.com
malingering/exp or Malinger*.ti,ab,kw,de or (feign* near/4 (psychopatholog* or symptom*)).ti,ab,kw,de or conscious-simulation.ti,ab,kw,de or pathomimia.ti,ab,kw,de
emergency health service*/exp OR emergency ward*/exp OR forensic medicine*/exp OR (Clinic* or veteran* or hospital* or outpatient* or inpatient*).ti,ab,kw,de OR emergicenter*.ti,ab,kw,de OR ((trauma NEAR/1 (patient* OR center* OR centre* OR department* OR unit* OR room*)).ti,ab) OR (((emergency OR emergencies) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR clinician* OR personnel OR patient* OR accidents)).ti,ab,kw,de) OR (((ems OR ed OR er) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR patient* OR personnel)).ti,ab,kw,de) OR (((ae* OR 'a e') NEAR/2 (department* OR admission* OR admitted)).ti,ab)
1 and 2
#3 NOT ('child'/exp NOT ('child'/exp AND 'adult'/exp))
#4 NOT ('case report'/exp OR 'validation study'/exp)
#5 AND [english]/lim
Web of Science
limit 5 to english language
Science Citation Index Expanded
(TS=(Malinger* or conscious-simulation or pathomimia)) OR (TS=(feign* near/4 (psychopatholog* or symptom*)))
(TS=(Clinic* or veteran* or hospital* or outpatient* or inpatient* OR emergicenter*)) OR (TS=((trauma NEAR/1 (patient* OR center* OR centre* OR department* OR unit* OR room*))) ) OR (TS=(((emergency OR emergencies) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR medicine OR visit* OR nurs* OR physician* OR clinician* OR personnel OR patient* OR accidents)) )) OR (TS=((ems OR ed OR er) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR patient* OR personnel)) )
1 and 2
#3 NOT ("child" NOT ("child" AND "adult"))
#4 NOT TS=("case report" OR "validation study")
#5 AND [english]/lim
APA PsycInfo
DE "Malingering" OR (AB=(Malinger* or conscious-simulation or pathomimia)) OR (TI=(Malinger* or conscious-simulation or pathomimia))
(DE="Emergency Medicine" OR DE="Emergency Services" OR DE="Hospital Admission" OR DE="Hospital Discharge" OR DE="Hospitals" OR DE="Hospitalization" OR DE="Hospitalized Patients") OR SU hospital* OR SU clinic* OR SU inpatient OR SU veteran OR (AB=(Clinic* or veteran* or hospital* or outpatient* or inpatient* OR emergicenter*)) OR (AB=((trauma NEAR/1 (patient* OR center* OR centre* OR department* OR unit* OR room*))) ) OR (AB=(((emergency OR emergencies) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR medicine OR visit* OR nurs* OR physician* OR clinician* OR personnel OR patient* OR accidents)) )) OR (AB=((ems OR ed OR er) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR patient* OR personnel)) ) OR (AB= (Clinic* or veteran* or hospital* or outpatient* or inpatient* OR emergicenter*)) OR (AB=((trauma NEAR/1 (patient* OR center* OR centre* OR department* OR unit* OR room*))) ) OR (TI=(((emergency OR emergencies) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR clinician* OR personnel OR patient* OR accidents)) )) OR (TI=((ems OR ed OR er) NEAR/3 (care OR service* OR dispatch* OR department* OR unit* OR ward* OR room* OR center* OR centre* OR system* OR stay* OR admit* OR admission* OR evaluation* OR assess* OR visit* OR nurs* OR physician* OR patient* OR personnel)) )
1 AND 2
SU test-validity
Proquest Dissertations and Theses Global
noft(malinger*) AND noft(hospital* OR emergency OR discharge* OR drug-seeking)
3 NOT 4
5 AND Narrow by Language: - english