When Munchausen becomes malingering: factitious disorders that penetrate the legal system.

S J Eisendrath
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Abstract

Psychiatrists and other physicians are usually familiar with factitious disorders, but attorneys and judges usually are not. Cases involving factitious disorders may enter the civil legal system in a number of ways and cause incorrect judgements, financial costs, and inappropriate medical care if these disorders are not identified. Psychiatric consultants may play a key role in identifying these cases and educating legal personnel about factitious disorders. This article describes three cases in which persons with factitious disorders entered the civil litigation system. The role of the psychiatrist in these cases is discussed. Clues to the identification of factitious disorders are described. The article also discusses the differentiation of factitious disorders from malingering and other forms of abnormal illness behavior, such as conversion, hypochondriasis, and somatization disorders. The concepts of primary and secondary gain in relationship to illness behaviors are elaborated.

当Munchausen装病时:渗透到法律体系的人为失调。
精神科医生和其他内科医生通常熟悉人为障碍,但律师和法官通常不熟悉。涉及人为精神障碍的案件可能以多种方式进入民事法律体系,如果这些疾病没有被识别,可能会导致错误的判决、经济成本和不适当的医疗。精神科顾问可能在识别这些病例和教育法律人员关于人为障碍方面发挥关键作用。本文描述了三个人为障碍患者进入民事诉讼制度的案例。讨论了精神科医生在这些病例中的作用。描述了识别人为障碍的线索。文章还讨论了人为障碍与装病和其他形式的异常疾病行为的区别,如转换、疑病症和躯体化障碍。阐述了与疾病行为相关的初级和次级增益的概念。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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