D'Andrea V J
J Clin Psychiatry. 1978 Mar;39(3):233-40.
Three cases of alleged and feigned cancer are presented. The diagnostic and management problems presented are discussed through a review of the literature of feigned illness. This ranges across a spectrum from benign use of feigned or alleged symptoms, malingering, conversion reactions and hysterical manifestations to the severe and flamboyant clinical presentation of the Munchausen Syndrome. The cases presented mainly fit the criterion for malingering (conscious prevarication and simulation), although some elements of the Munchausen dynamics were present in two of the three. Also noteworthy was the fact that the "cancers" were presented to administration and lay people as an initial communication. The psychiatric consultation was with the lay people initially and the events of each episode were reconstructed through multiple sources of information including clinical interviews in two of the cases.
本文介绍了三例疑似伪装癌症的病例。通过回顾伪装疾病的文献,对所呈现的诊断和管理问题进行了讨论。这涵盖了从伪装或疑似症状的良性使用、诈病、转换反应和癔症表现到孟乔森综合征严重且夸张的临床表现等一系列情况。所呈现的病例主要符合诈病的标准(有意识的推诿和伪装),尽管三例中有两例存在一些孟乔森综合征的动态因素。同样值得注意的是,“癌症”最初是向管理层和非专业人员报告的。最初是与非专业人员进行精神科会诊,并且通过多种信息来源(包括其中两例的临床访谈)对每个事件进行了重构。