功能叠加：一种不合理的诊断？

Functional overlay: an illegitimate diagnosis?

作者信息

Bromberg W

出版信息

West J Med. 1979 Jun;130(6):561-5.

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1238729/

Abstract

Functional overlay is not a recognized psychiatric diagnosis. Evaluating functional overlay and differentiating between this concept and organic conditions is important in medicolegal areas in which financial values are placed on pain and disability. Functional overlay is not malingering: the former is based on preconscious or unconscious mechanisms, the latter is consciously induced. In considering psychologic reactions to pain and disability, a gradient of simulation, malingering, symptom exaggeration, overvaluation, functional overlay and hysteria is useful. The dynamics of overlay are a combination of anxiety from body-image distortion and depression from decreased efficiency of the body, as well as the resulting psychosocial disruption in a patient's life.

摘要

功能性叠加并非一种公认的精神疾病诊断。在涉及疼痛和残疾存在经济价值考量的法医学领域，评估功能性叠加并区分这一概念与器质性疾病十分重要。功能性叠加并非诈病：前者基于前意识或无意识机制，后者是有意识诱发的。在考量对疼痛和残疾的心理反应时，模拟、诈病、症状夸大、过度重视、功能性叠加和癔症的梯度划分是有用的。叠加的动态变化是身体形象扭曲所致焦虑、身体机能下降所致抑郁以及患者生活中由此产生的社会心理紊乱的综合表现。

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本文引用的文献

1

The functional overlay.

Lancet. 1967 Dec 2;2(7527):1196-200. doi: 10.1016/s0140-6736(67)91909-5.

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Simulation and malingering after injuries to the brain and spinal cord.脑与脊髓损伤后的伪装及诈病

Lancet. 1972 Mar 11;1(7750):580-5. doi: 10.1016/s0140-6736(72)90368-6.

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