Medical and Nonmedical Fainting: Separating the Sheep from the Goats

Abstract

In recent times, the Nigerian public space has been awash with various incidences of “fainting” during investigations seeking to unravel issues surrounding alleged financial mismanagement in public institutions. A critical question is, to what extent do these apparent fainting behaviors represent a true illness‑related event? Feigning of medical symptoms for external gains is well‑described phenomenon with enormous cost to both forensic and nonforensic settings. Separating the sheep from the goats in these situations is a task many clinicians are not familiar with. This article aims to articulate the current models of malingering and to highlight the various ways of detecting deception in clinical settings. The authors opine that an integrative strategy, which involves the combination of various approaches with emphasis on the verbal and nonverbal signals during clinical interviews coupled with psychological testing and perhaps neuroimaging techniques, may improve the detection of deception in the clinical setting. We recommend that clinicians should not shy away from employing any of these “malingering diagnostic” approaches when there is a reasonable suspicion to the veracity of patients’ symptoms such as fainting during a panel inquiry.