Gattaz W F, Dressing H, Hewer W
Central Institute of Mental Health, Mannheim, FRG.
Psychopathology. 1990;23(1):33-9. doi: 10.1159/000284635.
A case report on a patient with Münchhausen syndrome is presented and the psychopathological features are compared to other reports in the literature. Diagnosis and differential diagnosis are discussed with regard to other somatoform disorders such as conversion disorder and somatization disorder as well as to malingering and cenesthesic schizophrenia. The management of Münchhausen syndrome is aggravated by the low compliance in these patients, who expose themselves to serious complications of unnecessary medical and surgical procedures. Early diagnosis could to a considerable extent exclude these iatrogenic risks. We recommend that patients presenting the psychopathological features of a Münchhausen syndrome should be conservatively observed and an attempt to clarify both the medical and the psychiatric diagnosis should be made before any invasive procedure is undertaken.
本文报告了一例孟乔森综合征患者，并将其精神病理学特征与文献中的其他报告进行了比较。讨论了孟乔森综合征与其他躯体形式障碍（如转换障碍和躯体化障碍）、诈病及体感型精神分裂症的诊断与鉴别诊断。这些患者依从性差，会使自己面临不必要的医疗和外科手术的严重并发症，从而加重了孟乔森综合征的治疗难度。早期诊断在很大程度上可以排除这些医源性风险。我们建议，对于具有孟乔森综合征精神病理学特征的患者，应进行保守观察，并在进行任何侵入性操作之前，尝试明确医学诊断和精神科诊断。
