Yapay Bozukluk
Özet
Yapay bozukluk, bireylerin maddi bir kazanç amacı gütmeden, yalnızca tıbbi ilgi ve bakım görmek adına hastalık semptomlarını kasıtlı ve planlı olarak taklit ettiği, başlattığı veya alevlendirdiği kompulsif özellikli bir durumdur. Hastalar, semptomlarının yalan olduğu anlaşıldığında farklı isim ve şikayetlerle başka merkezlere başvurdukları için "hastane gezginleri" olarak da adlandırılırlar. Görülme sıklığı tam bilinmemekle birlikte, vakaların çoğunun 20-50 yaş aralığındaki kadınlar ve sağlık çalışanları olduğu, ayrıca çocukluk çağı travmaları ile istismarın etiyolojide önemli rol oynadığı gözlenmiştir. Klinik olarak hastalar, tutarsız tıbbi öyküler ve tıbbi terminolojiye hakimiyet gibi özellikler sergileyerek sıklıkla fiziksel yakınmalarla başvururlar. Teşhisi zor olan bu rahatsızlık, DSM-5'te "kendine yüklenen" ve "bir başkasına yüklenen" (genellikle ebeveyn-çocuk ilişkisinde görülen) yapay bozukluk olarak iki alt kategoriye ayrılır. Ayırıcı tanıda bilinçli dış kazanç barındıran simülasyon ve bilinçdışı semptomlar içeren somatoform bozukluktan ayrılmalıdır. Belirli bir ilaç tedavisi olmayan bu bozuklukta en etkili yöntem psikoterapidir.
Factitious disorder is a compulsive condition in which individuals intentionally and deliberately simulate, initiate, or exacerbate disease symptoms solely to receive medical attention and care, without aiming for any material gain. Patients are also called "hospital hobos" because they apply to different centers with distinct complaints or names when it is detected that their symptoms are not real. Although its prevalence is not fully known, it has been observed that most cases are women between the ages of 20-50 and healthcare professionals, and childhood traumas and abuse play a significant role in its etiology. Clinically, patients usually present with physical complaints, displaying features such as inconsistent medical histories and extensive knowledge of medical terminology. This disorder, which is difficult to diagnose, is divided into two subcategories in DSM-5 as factitious disorder imposed on self and factitious disorder imposed on another, which is generally seen in the parent-child relationship. In differential diagnosis, it must be distinguished from malingering, which involves a conscious external gain, and somatoform disorder, which involves unconscious symptoms. Psychotherapy is the most effective method for this disorder, which has no specific medication treatment.
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