假神经转换与人为障碍2例临床鉴别诊断

J M Bertolín, M A Cervelló, R Gómez-Ferrer, C Peiró, V Iñigo, J López-Trigo
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引用次数: 0

摘要

当转换性和人为障碍与生理问题共存且其精神病理不明显时,其识别和区分可能是困难的。我们提出了两个说明性的病例,患者共享神经系统疾病的存在,并提出了类似的精神符号学,这是现象学上不同的与他们的身体缺陷相关。精神病理评估是通过标准化的诊断工具(扫描)和合适的临床技术为每个病例。两例患者均采用MMPI(明尼苏达多相人格量表)测试,其中一例患者使用硫喷妥钠进行探索。本文阐述了针对性的鉴别诊断、跨学科协调干预以阐明这些精神障碍的优势,以及使用适当的心理测量工具和探索性方法的便利性。
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[Pseudoneurologic conversion and factitious disorders: differential diagnosis in 2 clinical cases].

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.

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