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In the context of a positive Hoover's sign, functional weakness (or "conversion disorder") is much more likely than malingering or factitious disorder. [3] Strong hip muscles can make the test difficult to interpret. [4] Efforts have been made to use the theory behind the sign to report a quantitative result. [5]
Symptoms of conversion disorder usually occur suddenly. Conversion disorder was typically observed in people ages 10 to 35, [7] affecting between 0.011% and 0.5% of the general population. [8] Conversion disorder presented motor or sensory symptoms including: Motor symptoms or deficits: Impaired coordination or balance
A factitious disorder is a mental disorder in which a person, without a malingering motive, acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms, purely to attain (for themselves or for another) a patient's role.
Ganser syndrome was listed under Factitious Disorder with Psychological Symptoms in the DSM-III. [13] The criteria of this category emphasized symptoms that cannot be explained by other mental disorders, psychological symptoms under the control of the individual, and the goal of assuming a patient role, not otherwise understandable given their circumstances.
There are multiple methods to evaluate malingering, such as the Minnesota Multiphasic Personality Inventory-2, which is the most validated test. Other tests include the Structured Interview of Reported Symptoms, which is used for psychiatric symptoms , and the Test of Memory Malingering (TOMM) , intended for false memory deficits. [ 18 ]
The result means that, of these, 24 will not be identified as having schizophrenia by use of FRS (42% of 57). Then, of the 43 people really without schizophrenia, 13 may be incorrectly diagnosed with schizophrenia by the FRS. For all three estimates there are important issues regarding patient selection, use of index test and reference standard.
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