気胸・気腹と、多彩な症状を呈した Factitious disorder の1例

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We reporeted a case of factitious disorder who, during the clinical course, was suspected to inject her own chest with a needle to make pneumothoraces and even pneumoperitonea. The patient was a 17-year-old female. From childhood, she was an "obedient and good girl" who showed rich academic achievement. When 13 years old, she had suffered from very severe hyperventilation syndrome and finally come to enter T-Hospital where she improved. But since then she became ambivalent toward the doctor in charge. Making herself a very troublesome patient, finally, she was referred to our hospital on July 8,1986. On physical examination and laboratory data, she had no problems except for hyperventilation and mild dehydration. During the clinical course, she began to show many curious symptoms including anorexia, difficulty in walking, diarrhea, "stopping the breath" etc. We treated her as occasion demands, although her clinical course was becoming more curious and complicated, until her selfmade pneumothoraces and pneumoperitoneum. Diagnosing her disease as factitious disorder, we entrusted the treatment of her somatic disorder to a surgeon, and started supportive psychological therapy. As we continued the therapy perseveringly, her inadequate behavior improved gradually. We consider that it's important "to know" the concept of factitious disorder, and even if the case were seemed irrecoverable, persistent continuation of supportive therapy is very significant.
日本心身医学会の論文
1990-10-01

気胸・気腹と、多彩な症状を呈した Factitious disorder の1例

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