Janofsky J S
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21287-7144, USA.
Bull Am Acad Psychiatry Law. 1994;22(4):489-97.
The diagnosis of Munchausen syndrome requires that a patient intentionally produce or feign physical symptoms with a psychological need to assume the sick role. To differentiate the disorder from malingering one must document the absence of an external incentive for the patient's behavior. Although malingering is a major topic of interest in forensic psychiatry, there has been no literature that looks at the Munchausen syndrome presenting in the civil forensic setting. This paper reports on two cases of the Munchausen syndrome that occurred in the areas of medical malpractice and workers' compensation. The cases highlight how the psychiatrist should approach these cases in the civil forensic setting. The malpractice case also illustrates how the disorder is viewed by an appellate court.
孟乔森综合征的诊断要求患者出于心理上对患病角色的需求，故意制造或伪装身体症状。为了将该病症与诈病相区分，必须记录患者行为不存在外部诱因。尽管诈病是法医精神病学中一个主要的研究课题，但尚无文献探讨在民事法医环境中出现的孟乔森综合征。本文报告了两例发生在医疗事故和工伤赔偿领域的孟乔森综合征病例。这些病例凸显了精神科医生在民事法医环境中应如何处理这些病例。医疗事故案例还说明了上诉法院对该病症的看法。
