Limosin Frédéric, Loze Jean-Yves, Rouillon Frédéric
Hôpital Albert-Chenevier, 40, rue de Mesly, 94000 Créteil.
Ann Med Interne (Paris). 2002 Dec;153(8):499-502.
Factitious disorders are characterized by self-produced symptoms and a chronic course, sometimes with severe complications. Pathomimia occurs more often in women, even though the Munchausen syndrome is found especially in men. Among the various clinical features of pathomimia, the most frequent are factitious fevers and cutaneous pathomimia. Factitious psychiatric disorders are not rare, such as factitious psychotic symptoms, mournings or post-traumatic stress disorders. The main elements of diagnostic orientation are the odd expression of the reported symptoms, a capricious and disconcerting course, as well as the multiplicity of the previous history, with many imprecise diagnoses. Concerning the psychopathology, and contrary to the simple simulation, immediate utility of the alleged symptoms is not the expected goal, one of the essential psychological motivations being to challenge the physician. Among comorbid pathological personalities, there seems to be some close relations between pathomimia and hysterical personality, whereas the Munchausen syndrome shares common features with antisocial personality.
诈病以自我产生的症状和慢性病程为特征,有时会伴有严重并发症。病理性模拟在女性中更为常见,尽管孟乔森综合征尤其多见于男性。在病理性模拟的各种临床特征中,最常见的是诈病性发热和皮肤性病理性模拟。诈病性精神障碍并不罕见,如诈病性精神病症状、哀悼或创伤后应激障碍。诊断导向的主要要素包括所报告症状的奇特表现、多变且令人困惑的病程,以及既往病史的多样性,存在许多不准确的诊断。关于精神病理学,与单纯的伪装不同,所谓症状的即时效用并非预期目标,其中一个重要的心理动机是挑战医生。在共病的病理人格中,病理性模拟与癔症性人格之间似乎存在一些密切关系,而孟乔森综合征与反社会人格有共同特征。