Seeing how it’s a topic that’s come up quite a bit lately, and by popular demand by group members, Tuesday at 2pm SLT, at Mental Health Retreat, we had a class on Münchausen syndrome. We learned about WHAT Münchausen syndrome is, TYPES for it, How Münchausen syndrome differs from hypochondria, RISK factors for developing Münchausen syndrome, where the NAME comes from, TREATMENT AND PROGNOSIS available as well as SYMPTOMS. (sources for this article come from wikipedia as well as discussions with group members)
WHAT IT IS?
Münchausen syndrome is a psychiatric factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves. It is also sometimes known as hospital addiction syndrome, thick chart syndrome, or hospital hopper syndrome.
How does it manifest?
Münchausen syndrome goes hand in hand with predominantly physical signs and symptoms, but they also have a history of recurrent hospitalization, travelling, and dramatic, untrue, and extremely improbable tales of their past experiences. People who have Münchausen syndrome are likely to be master manipulators or have a tendency to lie a lot and a flair for the dramatic.
Types of Münchausen
a) Münchausen syndrome is related to Münchausen syndrome by proxy. This refers to the abuse of another person, typically a child, in order to seek attention or sympathy for the abuser. In Münchausen syndrome by proxy, there is an obsessive want to create symptoms for the victim in order to obtain repeated medication or even operations.
In Münchausen syndrome, the affected person exaggerates or creates symptoms of illnesses in themselves to gain investigation, treatment, attention, sympathy, and comfort from medical personnel. In some extreme cases, people suffering from Münchausen’s syndrome are highly knowledgeable about the practice of medicine and are able to produce symptoms that result in lengthy and costly medical analysis, prolonged hospital stay and unnecessary operations. The role of “patient” is a familiar and comforting one, and it fills a psychological need in people with this syndrome.
b) Another type is Arrhythmogenic Münchausen syndrome. This describes individuals who simulate or stimulate cardiac arrhythmias to gain medical attention.
Take note that this disorder is distinct from hypochondria in that those patients with the latter do not intentionally produce their somatic symptoms. So while hypochondriacs actually believe they are sick, Münchausen patients KNOW they are not.
Risk factors for developing Münchausen syndrome ( a.k.a. Why they do it)
Reasons for developing Münchausen syndrome include childhood traumas, growing up with parents/caretakers who were emotionally unavailable due to illness or emotional problems, a serious illness as a child, failed aspirations to work in the medical field, personality disorders, and a low self-esteem.
It seems that Münchausen syndrome is more common in men and seen in young or middle-aged adults. Those with a history of working in healthcare are also at greater risk of developing it.
A bit of side note, here’s article where a mom had faked being pregnant with twins and faked their death in order to get attention from her husband and family.
Where does the syndrome name come from?
The syndrome name derives from Baron Münchhausen (Karl Friedrich Hieronymus Freiherr von Münchhausen, 1720–1797), a German nobleman working in the Russian army, who purportedly told many fantastic and impossible stories about himself, which Rudolf Raspe later published as The Surprising Adventures of Baron Münchhausen.
In 1951, Richard Asher was the first to describe a pattern of self-harm, wherein individuals fabricated histories, signs, and symptoms of illness. Remembering Baron Münchhausen, Asher named this condition Münchausen’s Syndrome in his article in The Lancet in February 1951.
Moving on to Treatment and Prognosis
As you can imagine, diagnosing Münchausen syndrome is quite difficult and medical professionals or doctors suspecting Münchausen’s in a patient should first rule out the possibility that the patient has an early stage disease that is not yet clinically detectable. This makes it quite easy for them to get the attention they crave.
Providers need to acknowledge that there is uncertainty in treating suspected Münchausen patients so that real diseases are not under-treated. Then they should take a careful patient history and seek medical records, to look for early deprivation, childhood abuse, or mental illness. If a patient is at risk to himself or herself, inpatient psychiatric hospitalization should be initiated.
Medical providers or doctors should consider working with mental health specialists to help treat the underlying mood or disorder as well as to avoid countertransference. Therapeutic and medical treatment should center on the underlying psychiatric disorder: a mood disorder, an anxiety disorder, or borderline personality disorder.
The patient’s prognosis depends upon the category under which the underlying disorder falls; depression and anxiety, for example, generally respond well to medication and/or cognitive behavioral therapy, whereas borderline personality disorder, like all personality disorders, is presumed to be pervasive and more stable over time.
Some symptoms that together point to Münchausen syndrome:
Patients may have multiple scars on abdomen due to repeated “emergency” operations.
Some have frequent hospitalizations, have knowledge of several illnesses, frequently requesting medication such as pain killers, openness to extensive surgery, little to no visitors during hospitalizations, exaggerated or fabricated stories about several medical problems, and more.
There are several ways in which the patients fake their symptoms. Other than making up past medical histories and faking illnesses patients might inflict harm on themselves such as taking laxatives or blood thinners, ingesting or injecting themselves with bacteria, cutting or burning themselves, and disrupting their healing process such as reopening wounds.
Many of these conditions do not have clearly observable or diagnostic symptoms and sometimes the syndrome will go undetected because patients will fabricate identities when visiting the hospital several times. Münchausen syndrome has several complications as these patients will go to great lengths to fake their illness. Severe health problems, serious injuries, loss of limbs or organs, and even death are possible complications.
So there you have it, a bit of info on Münchausen syndrome. What’s your take on this disorder and the ways the Münchausen patients act? Feel free to voice your opinion in comments, we value your input!