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題名 | 甘瑟氏症候群:一例報告=Ganser's Syndrome: A Case Report |
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作者 | 徐堅棋; 孫藝文; 何志仁; 吳光顯; Hsu, Chien-chi; Sun, Yi-wen; Ho, Chih-jen; Wu, Kuang-hsien; |
期刊 | 臺灣精神醫學 |
出版日期 | 20000300 |
卷期 | 14:1 2000.03[民89.03] |
頁次 | 頁63-71 |
分類號 | 415.8732 |
語文 | chi |
關鍵詞 | 甘瑟氏症候群; 歇斯底里; 解離狀態; Ganser's syndrome; Hysteria; Dissociation; |
中文摘要 | 目的:甘瑟氏症候群為一罕見的精神症候群,主要臨床特徵為『近似正確回答』,意識障礙,身體轉化症狀及併有視聽幻覺。發生病因仍多爭議,但較偏於是一種解離狀態。患者多在面對一些無法忍受的情境下而突然出現精神症狀。本文擬提出一典型個案,就其臨床表現、精神病理學、治療經驗及預後追蹤做一報告,並與以往文獻做一比較。病例報告:一位38歲女性,在面臨家庭及心理社會衝突時,突然出現急性精神症狀,其臨床表徵與甘瑟氏症候群的描述吻合,沒有發現任何器質性問題。使用精神藥物,藥物催眠和電痙攣治療,均未獲改善;而針對其心理社會衝突的處理並予隔離後,也僅能短暫緩解。只有環境配合改變及協調後,症狀才戲劇性消失。長達一年的追蹤,無藥物控制,均未再發作,此時個案已遺忘住院一切經過。結論:由治療經驗中,我們亦認為此現象是一種歇斯底里性的解離狀態,患者面對無法處理的現實環境或衝突下,藉由潛意識的力量產生歇斯底里的症狀,來逃避責任或威脅。在嘗試過去文獻中的不同治療方式後,發現或許只有排除其他可能致病原因,針對其原本收穫和附帶收穫去處理,並解決其現實衝突,才能得到較好的治療結果。 |
英文摘要 | Objective: Ganser's syndrome is a rare psychiatric syndrome. Its clinical features include approximate answers, clouding of consciousness, somatic conversion symptoms, and hallucination. Although the etiology of Ganser's syndrome is still controversial, modern classifications categorize it as an unspecified dissociative disorder. It may occur as a result of an unconscious effort by the subject to escape from an intolerable situation. Here we describe a typical case of Ganser's syndrome together with discussion of its psychopathology, management, course and prognosis. Case Report: A 38-year-old woman manifested clinical symptoms of Ganser's syndrome including approximate answers, disorientation, fainting, amnesia and hallucination. No congruent organic factor was found. She was unresponsive to a wide variety of treatments including antipsychotics, antidepressants, hypnosis and electroconvulsive therapy. Surprisingly, she recovered spontaneously and dramatically at four weeks after last discharge; and she later attributed the spontaneous recovery to the solution of previous psychosocial stressors. At one-year follow up, she showed none of the previous symptoms and was amnesic about hospitalization. Conclusion: The findings of this case support the original hypothesis that Ganser's syndrome is a form of hysterical dissociative state. Identifying and dealing with the actual intolerable life situation may be the most effective approach to management. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。