精神科詐病役男之特徵

Characteristics of the Draftees with Suspected Malingering

江允志(Yung-Chih Chiang) ； 曾冬勝(Dong-Sheng Tzeng) ； 周植強(Philip C. K. Chow) ； 張琦(Chi Chang) ； 潘志泉(Chih-Chuan Pan) ； 陸悌(Ti Lu) ； 張正和(Cheng-Ho Chang) ； 鄧光銳(Kwong-Yui Tang)

《台灣精神醫學》 20卷2期 (2006/06) Pp. 145-154

https://doi.org/10.29478/TJP.200606.0007

摘要

目的：國內外有關精神科兵役複檢及役男詐病的研究並不多，本研究之目的在瞭解以精神科病症為主訴的役男，其各項特質及常見之詐病模式。方法：本研究為一回溯性研究，蒐錄從90年7月至91年6月所有轉介至台灣南部某醫學中心精神科住院作兵役複檢的77位役男，收集其人口學資料、初檢醫院資料、本院鑑定資料及兵役處（局）判定之體位等，並分析疑似詐病及無詐病之役男在各變項的差異性。結果：經過兵役複檢後，役男的主要診斷以精神分裂症最多，佔15.6%，其次為重度憂鬱症，佔13.0%。有35.1%的役男有修訂其原始診斷，有9.1%（7人）被判定為疑似詐病者。疑似詐病者之精神病史平均長度為6.3±6.2月，顯著低於無詐病者的22.4±24.4月(p=0.030)。7位疑似詐病役男的複檢後主要診斷，有6位是適應障礙，而其初檢醫院之原始診斷，有5位是情感性疾患。結論：精神科兵役複檢常見之一種疑似詐病模式是偽裝情感性疾患，而其複檢後主要診斷大多是適應障礙，此外，精神病史較短的役男，要留意詐病的可能性。

關鍵字

兵役 ； 役男 ； 複檢 ； 詐病

並列摘要

Objective: Little research has been done on the correlates of malingering among military service personnel. This study analyzed the characteristics of service personnel seeking psychiatric reevaluation with the intention of being released from military duty in order to distinguish between malingerers and non-malingerers. Methods: Subjects were recruited from 77 draftees who visited our medical center for a second psychiatric evaluation from between July 2001 and June 2002. Data were collected on the following characteristics: demographic features; results of first and second clinical psychiatric evaluations; and physical constitutional ranking, a measure of physical fitness for service as rated by the Military Service Office were collected. Data were analyzed descriptively. Results: Schizophrenia was diagnosed in 15.6% of draftees and major depression in 13.0%. The original psychiatric diagnosis was later revised in 35.1% of the draftees including 9.1% of cases with suspected malingering. Suspected malingerers had a history of psychiatric problems averaging 6.3±6.2 months, a significantly shorter period than for non-malingerers (22.4±24.4 months, p=0.030). Adjustment disorder was diagnosed in 6 out of 7 suspected malingerers at re-evaluation; however, 5 had mood disorder at the original diagnosis. Conclusion: One of the suspected strategies for malingering among draftees is simulation of mood disorders, and most suspected draftees had adjustment disorders diagnosed on re-evaluation. Military service personnel with a short psychiatric history should be carefully evaluated for malingering.

並列關鍵字

military service ； draftee ； re-evaluation ； malingering

參考文獻

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內政部線上申辦服務系統

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