Feldman M D, Rosenquist P B, Bond J P
Department of Psychiatry & Behavioral Neurobiology, University of Alabama at Birmingham, USA.
Gen Hosp Psychiatry. 1997 Jan;19(1):24-8. doi: 10.1016/s0163-8343(96)00108-9.
Two forms of medical dissimulation-factitious disorder and factitious disorder by proxy-present enormous challenges to clinicians accustomed to receiving valid symptom reports from their patients. The consequences of such "disease forgery" are heightened when a patient simultaneously engages in both forms of deception. We discuss a 34-year-old nurse who simulated or induced a panoply of physical and psychological ailments in both herself and her daughter. The staff's insistence on access to outside information sources proved indispensible in establishing both diagnoses, facilitating ongoing treatment for the patient and ensuring appropriate protection of the child.
两种形式的医学伪装——做作性障碍和代理型做作性障碍——给习惯从患者那里获得有效症状报告的临床医生带来了巨大挑战。当患者同时采用这两种欺骗形式时，这种“疾病伪造”的后果会更加严重。我们讨论了一名34岁的护士，她在自己和女儿身上伪装或诱发了一系列身心疾病。事实证明，工作人员坚持获取外部信息来源对于确立这两种诊断、促进对患者的持续治疗以及确保对儿童的适当保护都不可或缺。
