Munchausen syndrome

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Munchausen Syndrome

 

Definition

Munchausen syndrome is a psychiatric disorder that causes an individual to self-inflict injury or illness or to fabricate symptoms of physical or mental illness, in order to receive medical care or hospitalization. In a variation of the disorder, Munchausen by proxy (MSBP), an individual, typically a mother, intentionally causes or fabricates illness in a child or other person under her care.

Description

Munchausen syndrome takes its name from Baron Karl Friederich von Munchausen, an 18th century German military man known for his tall tales. The disorder first appeared in psychiatric literature in the early 1950s when it was used to describe patients who sought hospitalization by inventing symptoms and complicated medical histories, and/or inducing illness and injury in themselves. Categorized as a factitious disorder (a disorder in which the physical or psychological symptoms are under voluntary control), Munchausen's syndrome seems to be motivated by a need to assume the role of a patient. Unlike malingering, there does not seem to be any clear secondary gain (e.g., money) in Munchausen syndrome.
Individuals with Munchausen by proxy syndrome use their child (or another dependent person) to fulfill their need to step into the patient role. The disorder most commonly victimizes children from birth to 8 years old. Parents with MSBP may only exaggerate or fabricate their child's symptoms, or they may deliberately induce symptoms through various methods, including poisoning, suffocation, starvation, or infecting the child's bloodstream.

Causes and symptoms

The exact cause of Munchausen syndrome is unknown. It has been theorized that Munchausen patients are motivated by a desire to be cared for, a need for attention, dependency, an ambivalence toward doctors, or a need to suffer. Factors that may predispose an individual to Munchausen's include a serious illness in childhood or an existing personality disorder.
The Munchausen patient presents a wide array of physical or psychiatric symptoms, usually limited only by their medical knowledge. Many Munchausen patients are very familiar with medical terminology and symptoms. Some common complaints include fevers, rashes, abscesses, bleeding, and vomiting. Common Munchausen by proxy symptoms include apnea (cessation of breathing), fever, vomiting, and diarrhea. In both Munchausen and MSBP syndromes, the suspected illness does not respond to a normal course of treatment. Patients or parents may push for invasive diagnostic procedures and display an extraordinary depth of knowledge of medical procedures.

Diagnosis

Because Munchausen sufferers often go from doctor to doctor, gaining admission into many hospitals along the way, diagnosis can be difficult. They are typically detected rather than diagnosed. During a course of treatment, they may be discovered by a hospital employee who encountered them during a previous hospitalization. Their caregivers may also notice that symptoms such as high fever occur only when the patient is left unattended. Occasionally, unprescribed medication used to induce symptoms is found with the patient's belongings. When the patient is confronted, they often react with outrage and check out of the hospital to seek treatment at another facility with a new caregiver.

Treatment

There is no clearly effective treatment for Munchausen syndrome. Extensive psychotherapy may be helpful with some Munchausen patients. If Munchausen syndrome co-exists with other mental disorders, such as a personality disorder, the underlying disorder is typically treated first.

Key terms

Apnea — A cessation of breathing.
Factitious disorder — A disorder in which the physical or psychological symptoms are under voluntary control.

Prognosis

The infections and injuries Munchausen patients self-inflict can cause serious illness. Patients often undergo countless unnecessary surgeries throughout their lifetimes. In addition, because of their frequent hospitalizations, they have difficulty holding down a job. Further, their chronic health complaints may damage interpersonal relationships with family and friends. Children victimized by sufferers of MSBP are at a real risk for serious injury and possible death. Those who survive physically unscathed may suffer developmental problems later in life.

Prevention

Because the cause of Munchausen syndrome is unknown, formulating a prevention strategy is difficult. Some medical facilities and healthcare practitioners have attempted to limit hospital admissions for Munchausen patients by sharing medical records. While these attempts may curb the number of hospital admissions, they do not treat the underlying disorder and may endanger Munchausen sufferers that have made themselves critically ill and require treatment. Children who are found to be victims of persons with Munchausen by proxy syndrome should be immediately removed from the care of the abusing parent or guardian.

Resources

Organizations

American Psychiatric Association. 1400 K Street NW, Washington DC 20005. (888) 357-7924. http://www.psych.org.
American Psychological Association (APA). 750 First St. NE, Washington, DC 20002-4242. (202) 336-5700. ttp://www.apa.org.
National Alliance for the Mentally Ill (NAMI). Colonial Place Three, 2107 Wilson Blvd., Ste. 300, Arlington, VA 22201-3042. (800) 950-6264. http://www.nami.org.
National Institute of Mental Health. Mental Health Public Inquiries, 5600 Fishers Lane, Room 15C-05, Rockville, MD 20857. (888) 826-9438. http://www.nimh.nih.gov.

Munchausen syndrome

 [mun´chow-zen]
habitual seeking of hospital treatment for apparent acute illness, the patient giving a plausible and dramatic history, all of which is false. It is a subtype of factitious disorder.

Mun·chau·sen syn·drome

(mūn'chow-zĕn), The name is correctly spelled Munchausen, not Munchhausen, Münchhausen, or Münchausen.
Repeated fabrication of clinically convincing simulations of disease for the purpose of gaining medical attention; a term referring to patients who wander from hospital to hospital feigning acute medical or surgical illness and giving false and fanciful information about their medical and social background for no apparent reason other than to gain attention. See: factitious disorder.

Munchausen syndrome

(mŭn′chou′zən, mŭnch′hou′-)
n.
A psychiatric disorder characterized by the repeated fabrication of disease signs and symptoms for the purpose of gaining medical attention.
The repeated simulation of severe organic disease, leading to numerous medical and/or surgical consultations, hospitalisations and unnecessary operations. This pseudodisease affects individuals who create bizarre lesions or fabricate symptoms to enjoy the perceived benefits of hospitalisation, as well as the attention and sympathy of others
Statistics Male:female ratio, 1:2; 74% develop the condition by age 24; the average patient is diagnosed by age 32.

Munchausen syndrome

Münchhausen syndrome Psychiatry A pseudodisease seen in subjects who create bizarre lesions or fabricate Sx, to enjoy the perceived benefits of hospitalization Statistics ♀:♂ ratio, 2:1; 74% develop the condition by age 24, and on average are diagnosed as having MS by age 32. See Munchausen-by-proxy syndrome.

Mun·chau·sen syn·drome

(mūn'chow-zĕn sindrōm)
Repeated fabrication of clinically convincing simulations of disease to get medical attention.
See: factitious disorder

Albatross,

large sea bird that figures prominently in Coleridge's poem, "The Rime of the Ancient Mariner."
Albatross syndrome - Synonym(s): Münchausen syndrome

Münchausen,

Baron Karl Friedrich Hieronymus von, German soldier and adventurer, 1720-1797.
Münchausen by proxy syndrome - a parent, usually knowledgeable about or experienced in health care, harming a child in order to gain the attention of healthcare providers.
Münchausen syndrome - repeated fabrication of clinically convincing simulations of disease for the purpose of gaining medical attention. Synonym(s): Albatross syndrome

van Gogh,

Vincent, Dutch artist, 1853-1890.
van Gogh syndrome - Synonym(s): Münchausen syndrome

Mun·chau·sen syn·drome

(mūn'chow-zĕn sindrōm)
Repeated fabrication of clinically convincing simulations of disease to gain medical attention.