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[假性神经症性转换障碍和做作性障碍:2例临床病例的鉴别诊断]

[Pseudoneurologic conversion and factitious disorders: differential diagnosis in 2 clinical cases].

作者信息

Bertolín J M, Cervelló M A, Gómez-Ferrer R, Peiró C, Iñigo V, López-Trigo J

机构信息

Hospital General Universitario, Diputación Provincial de Valencia.

出版信息

Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1998 Jan-Feb;26(1):58-62.

PMID:9580356
Abstract

The recognition and differentiation of conversion and factitious disorders could be difficult when they coexist with physical problems and their psychopathology is not evident. We present two illustrative cases of patients who share the existence of neurological disorders and present a similar psychiatric semiology, which is phenomenologically different related with their physical deficits. The psychopathological assessment was made by means of a standardized instrument for diagnosis (SCAN) and suitable paraclinical techniques for each case. The test MMPI (Minnesota Multiphasic Personality Inventory) was used in both cases, and an exploration with Thiopental was carried out in one of them. The pertinent differential diagnosis, the advantages of coordinated interdisciplinary interventions in order to elucidate these mental disorders, and the convenience of using appropriated psychometric instruments and exploratory methods are expounded in the present paper.

摘要

当转换障碍和做作性障碍与躯体问题并存且其精神病理学表现不明显时,对它们的识别和区分可能会很困难。我们展示了两个具有说明性的病例,这两位患者都存在神经障碍且呈现出相似的精神科症状学表现,但在现象学上与他们的躯体缺陷相关的表现有所不同。通过标准化诊断工具(SCAN)以及针对每个病例的适当辅助临床技术进行精神病理学评估。两个病例均使用了明尼苏达多相人格调查表(MMPI)测试,其中一个病例还进行了硫喷妥钠试验。本文阐述了相关的鉴别诊断、为阐明这些精神障碍而进行跨学科协调干预的优势,以及使用适当心理测量工具和探索性方法的便利性。

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