Other conditions that may be a focus of clinical attention
- Topic
Problems that are not mental disorders but shape health and care: troubled relationships, abuse and neglect, money and housing, and malingering.
What it is
Some problems that are not mental disorders still bring people to care or change the course and treatment of an illness. The DSM lists relational problems, such as partner and parent-child relational problems and child or partner maltreatment, among the other conditions that may be a focus of clinical attention, as codes rather than diagnoses. This page also covers abuse of children and older people, economic hardship and malingering, which shape risk and care in the same way. Recording these problems makes the social side of illness visible and guides referrals without turning normal life difficulties into psychiatric diagnoses.
Key facts
- Relational problems include partner relational problems, parent-child relational problems and child or partner maltreatment; dissatisfaction with a partner is linked to depression.
- About 1 in 6 people aged 60 or older suffered some form of abuse in the community in the past year, most often psychological abuse, according to WHO.
- In the United States, at least 1 in 7 children experienced abuse or neglect in a recent year, and the true number is likely higher, according to CDC.
- Children in families with low socioeconomic status suffer abuse and neglect about five times more often, which is why housing and economic problems belong in the history.
- Risk factors for abuse of older people include functional dependence or disability, cognitive impairment and poor mental health.
The main groups and why they matter
| Group | Examples | Why it matters clinically |
|---|---|---|
| Relational problems | Partner or parent-child problems | Linked to adherence, rehospitalization and children's adjustment |
| Child abuse and neglect | Physical, sexual and emotional abuse; neglect | At least 1 in 7 US children a year; underreported |
| Spouse or partner violence | Partner maltreatment, including physical abuse | Ask privately; plan for safety |
| Abuse of older adults | Psychological, financial, physical or sexual abuse; neglect | About 1 in 6 people aged 60+ a year; linked to dependence and cognitive impairment |
| Housing and economic problems | Poverty, low socioeconomic status | Child abuse and neglect about five times more common |
| Malingering | Symptoms falsified on purpose for an external gain | Neither a somatic symptom disorder nor a factitious disorder |
Clinical notes
- Ask about relationships, safety, money, housing, work or school as part of every psychiatric history, and record the problems found.
- When abuse is suspected, see the person alone, document injuries and statements objectively, plan for safety and report as the law requires.
- Consider couple or family interventions when relationships are part of the problem.
- Refer to social work, legal aid, school services or community resources, since many of these problems are not solved by medicines.
Test yourself
Think of the answer, then tap the question to see it.
What defines malingering?
Intentionally falsified symptoms for an external gain, such as money, avoiding legal consequences or avoiding work.
How does factitious disorder differ from malingering?
Both involve symptoms produced on purpose, but factitious disorders are driven by internal needs, such as attention or sympathy, rather than by an external gain.
About how many people aged 60 or older experience abuse in community settings each year, and which type is most common?
Around 1 in 6; psychological abuse is the most common type.
How does conflict between partners affect their children?
It is associated with worse parenting and worse child adjustment.
Elsewhere in DurgiPedia
- Malingering in forensic settings
- Mandatory reporting: public health, violence and abuse
- Intimate-partner and gender-based violence
- Child maltreatment: signs that should raise concern
Connections
Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.
Sources: Overview of Somatization (MSD Manual Professional Edition, 2026); About Child Abuse and Neglect (Centers for Disease Control and Prevention (CDC), 2024); Abuse of older people (World Health Organization (WHO), 2024); Relationship problems and the DSM: needed improvements and suggested solutions (World Psychiatry (PubMed Central), 2009).
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