Munchausen综合征(MS)已被广泛认为是人为障碍的严重表现,个人为了心理满足而故意捏造或夸大症状的情况。由于其难以捉摸的性质和与各种医疗状况的复杂关系,它代表了复杂的诊断挑战。我们介绍了一个在联络精神病学背景下观察到的44岁女性的临床病例,展示了慢性病之间复杂的相互作用,精神因素,以及诊断和管理MS的挑战患者有反复住院史,难以治愈的伤口,以及对外科手术的明显偏好。尽管诊断困难和治疗依从性差,涉及整形手术的多学科团队方法,骨科,物理医学,和康复,除了联络精神病学,导致MS合并慢性骨髓炎的诊断,最终需要经胫骨截肢。该案强调了及早发现的重要性,多学科方法,联络精神病学在管理MS中的作用虽然早期诊断可能不会改变病程,它可以防止不必要的干预措施并减轻相关风险。此案还强调了持续的精神支持和家庭参与解决自我伤害行为复发的必要性。进一步的研究对于增强我们的理解和制定有效的MS治疗策略至关重要,有助于提高这种具有挑战性的精神疾病的诊断精度和整体管理。
Munchausen Syndrome (MS) has been widely recognized as a severe manifestation of factitious disorder, a condition where individuals intentionally fabricate or exaggerate symptoms for psychological gratification. It represents a complex diagnostic challenge due to its elusive nature and intricate relationship with various medical conditions. We present a clinical
case of a 44-year-old woman observed in the context of Liaison Psychiatry, demonstrating the intricate interplay between chronic medical conditions, psychiatric factors, and the challenges in diagnosing and managing MS. The patient exhibited a history of recurrent hospitalizations, difficult-to-heal injuries, and a pronounced preference for surgical interventions. Despite diagnostic difficulties and poor therapeutic adherence, a multidisciplinary team approach involving plastic surgery, orthopedics, physical medicine, and rehabilitation, alongside Liaison Psychiatry, led to the diagnosis of MS with chronic osteomyelitis, ultimately necessitating a transtibial amputation. The
case underscores the importance of early detection, a multidisciplinary approach, and the role of Liaison Psychiatry in managing MS. While early diagnosis may not alter the disease course, it can prevent unnecessary interventions and mitigate associated risks. The
case also highlights the need for continuous psychiatric support and family involvement in addressing the recurrence of self-injurious behaviors. Further research is essential to enhance our understanding and develop effective treatment strategies for MS, contributing to improved diagnostic precision and overall management of this challenging psychiatric disorder.