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PubMed1987

Cerebral dysfunction in the Munchausen syndrome.

Brain dysfunction has been noted Munchausen syndrome patients but rarely explored. We describe five Munchausen syndrome patients who all appeared intellectually intact because of their excellent verbal skills. However, formal neuropsychological assessment testing revealed deficits in conceptual organization, management of complex information, and judgement. We suggest that subtle but important neuropsychological impairment may contribute significantly to the aberrant behavior of Munchausen syndrome patients. Typical Munchausen behaviors such as irascibility, the desperate search for care, and pseudologia fantastica, may be understood as solutions to problems created by brain damage.

Adolescent↗

PubMed1974

[Social and legal problems in the so-called poriomania, with special reference to desertion and AWOL].

Following a synopsis of the main bibliography and a number of own cases it could be pointed out that the so-called poriomania is accompanied with punishable acts in about one-third of all cases. An analysis of the different delicts yielded as result a clear preponderance of larcency of money, fraud and embezzlement - in comparison with desertion and absence without official leave. Only 20% of all cases with punishable acts were denounced. In former times, up to the first world war, about a percentage of 74 of all criminal cases in connection with poriomania was exonerated on the erroneous assumption that the behaviour of the so-called poriomania would be caused by epilepsy. About one third of all persons with poriomania are feebleminded. There is a high inclination to fraud, pseudologia, abuse of alcohol and prostitution. An enlarged inclination (15%) to suicide is also remarkable. A familiar accumulation of poriomania does not justify the supposition of an endogenous factor. Therefore criminal acts in connection with poriomania connot be exonerated. The personality of men with poriomania is characterised by unsteadiness, unstableness and velleity.

Adolescent↗

PubMed1996

Cerebellar arachnoid cyst in a firesetter: the weight of organic lesions in arson.

A 52-year-old female patient was accused of arson; the patient had had an arachnoid cyst of the cerebellar vermis. Even after surgery, she showed marked instability of mood and pseudologia fantastica, but did not suffer from cognitive impairment. Possible associations of the presence of this cerebellar arachnoid cyst and behavioral disturbances are discussed.

Arachnoid Cysts↗

PubMed1997

The differential diagnosis of ritual abuse allegations.

OBJECTIVE: Because psychiatrists do not have a consistent way to classify and define the forms of child abuse that may be mistaken for ritual abuse, the objective of this paper is to create a comprehensive differential diagnosis of allegations of ritual abuse. METHOD: The authors reviewed 60 articles, chapters, and books that contained allegations of ritual abuse or behaviors that might be mistaken for ritual abuse, that were made by patients or caretakers. RESULTS: This paper clarifies the behaviors that represent or may be mistaken for ritual abuse: Cult-based ritual abuse, pseudoritualistic abuse, activities by organized satanic groups, repetitive psychopathological abuse, sexual abuse by pedophiles, child pornography portraying ritual abuse, distorted memory, false memory, false report due to a severe mental disorder, pseudologia phantastica, adolescent behavior simulating ritual abuse, epidemic hysteria, deliberate lying, and hoaxes. CONCLUSIONS: The differential diagnosis of allegations of ritual abuse is important in both clinical and forensic psychiatry. In some cases, it will not be possible to tell whether a particular allegation is factual or what the underlying mental processes are. It is important to separate the role of the mental health professional as therapist from the role as an expert witness in court.

Child↗