虚假的疾病和模仿:临床评估和管理的挑战
Christopher Bass1, Peter Halligan2
1Department of Psychological Medicine, John Radcliffe Hospital, Oxford, UK.
Lancet (London, England)
|March 12, 2014
概括
诊断虚假疾病需要仔细收集信息和团队方法. 了解疾病欺骗,假装和寻求健康的异常行为对于有效的患者管理至关重要.
科学领域:
- 精神病学是一个精神病学.
- 医学心理学 医学心理学
背景情况:
- 虚假疾病很少被诊断出来,往往需要详细的病史和医疗记录审查才能确定.
- 欺骗是虚假疾病的核心,带来诊断挑战,特别是在儿童,妇女和医疗保健工作者方面.
研究的目的:
- 突出诊断的挑战和管理策略为虚假的障碍和模仿.
- 强调需要加强医疗教育,以识别和管理模拟症状.
主要方法:
- 系统地收集信息,包括详细的时间表和医疗记录审查.
- 使用心理测量调查,如症状有效性测试,以采访和医学/非医学证据为依据.
- 采用以团队为基础的管理方法,涉及初级保健医生.
主要成果:
- 诊断依赖于全面的数据,因为单独的临床技能不足以检测疾病欺骗或伪装.
- 恶意欺诈在临床实践中不那么常见,而在医疗法律环境中,财务动机是关键.
- 从多个来源汇聚证据对于准确检测模拟症状至关重要.
结论:
- 有效地管理虚假的疾病和模仿需要一个多学科的方法和强大的诊断框架.
- 医学教育必须使医生具备应对模拟症状患者的技能.
- 未来的进步需要整合来自社会神经科学,职业健康和临床心理学的见解,以及非医学因素.
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