Bauer M, Boegner F
Department of Psychiatry, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Germany.
J Nerv Ment Dis. 1996 May;184(5):281-8. doi: 10.1097/00005053-199605000-00003.
Factitious disorder is characterized by the intentional feigning of physical or psychological signs and symptoms. The best known type of factitious disorder, Munchausen syndrome, is marked by a chronic unremitting course with repeated hospitalizations. The purpose of this study was to assess the frequency, psychopathological phenomenology, and diagnostic classification according to DSM-III-R in patients with factitious disorder presenting as neurological syndromes. We prospectively included all patients who were hospitalized at our Department of Neurology, Freie Universität Berlin, during a 1-year period. Five of 1538 (.3%) patients were diagnosed as having factitious disorder with feigning of neurological syndromes. Four presented with the classic variant, Munchausen syndrome. All patients had similar, characteristic psychopathological features including self-discharge, aggressive behavior, pseudologia phantastica, and hospital wandering. In these cases the additional diagnosis of personality disorder was made according to DSM-III-R criteria. We concluded that factitious disorder presenting with neurological syndromes may be more prevalent than generally assumed. Our findings confirm the idea of frequent coincidence of factitious and personality disorders.
做作性障碍的特征是故意伪装身体或心理症状和体征。最广为人知的做作性障碍类型，孟乔森综合征，其特点是病程慢性且持续，反复住院。本研究的目的是评估表现为神经综合征的做作性障碍患者的发生率、心理病理现象学以及根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）的诊断分类。我们前瞻性纳入了在柏林自由大学神经科住院一年期间的所有患者。1538名患者中有5名（0.3%）被诊断为伪装神经综合征的做作性障碍。4名表现为典型的孟乔森综合征变体。所有患者都有相似的特征性心理病理特征，包括自我出院、攻击行为、虚构症和医院徘徊。在这些病例中，根据DSM-III-R标准做出了人格障碍的附加诊断。我们得出结论，表现为神经综合征的做作性障碍可能比一般认为的更为普遍。我们的发现证实了做作性障碍和人格障碍经常同时出现的观点。
