Toth E L, Baggaley A
Department of Medicine, University of Alberta.
Psychiatry. 1991 May;54(2):176-83; discussion 184-6. doi: 10.1080/00332747.1991.11024545.
Patients with factitious disorders represent an important challenge to medical and psychiatric caregivers. The literature on Munchausen's syndrome abounds with entertaining descriptions of these flamboyant patients, but rarely is there significant understanding of the mechanisms of the disease. We present a case where Munchausen's syndrome coincided with multiple personality disorder (MPD). The patient has been known to us for over 10 years, and some resolution of the Munchausen's syndrome is occurring in response to appropriate therapy for the multiple personality disorder. We point out the need to seek out dissociative phenomena in self-abusive patients, as this may provide a clue for psychodynamic understanding and rational therapy.
诈病患者给医学和精神科护理人员带来了重大挑战。关于孟乔森综合征的文献充斥着对这些行为夸张的患者的有趣描述，但对该疾病的发病机制却鲜有深入了解。我们报告一例孟乔森综合征与多重人格障碍（MPD）并存的病例。该患者为我们所知已有十余年，针对多重人格障碍的适当治疗正在使孟乔森综合征得到一定程度的缓解。我们指出，有必要在自我虐待患者中寻找解离现象，因为这可能为心理动力学理解和合理治疗提供线索。
