Münchausen syndrome is a term for psychiatric disorders known as Factitious disorders wherein those affected feign disease, illness, or psychological trauma in order to draw attention or sympathy to themselves. It is also sometimes known as
hospital addiction syndrome or
hospital hopper syndrome.
Münchausen syndrome is related to
Münchausen syndrome by proxyMünchausen syndrome by proxy , referred to in the DSM-IV-TR as Factitious Disorder by Proxy, is a disorder in which a person deliberately causes injury or illness to another person, usually to gain attention or some other benefit. Münchausen by proxy has been described by some as a form of extended...
(MSbP/MSP), which refers to the abuse of another being (typically a child) as a result of having a psychological disorder.
In Munchausen syndrome, the affected person exaggerates or creates
symptomA symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s of
illnessIllness can be defined as a state of poor health. Illness is sometimes considered a synonym for disease. Others maintain that fine distinctions exist...
es in themselves or their child/children in order to gain investigation, treatment, attention, sympathy, and comfort from medical personnel.
Münchausen syndrome is a term for psychiatric disorders known as Factitious disorders wherein those affected feign disease, illness, or psychological trauma in order to draw attention or sympathy to themselves. It is also sometimes known as
hospital addiction syndrome or
hospital hopper syndrome.
Münchausen syndrome is related to
Münchausen syndrome by proxyMünchausen syndrome by proxy , referred to in the DSM-IV-TR as Factitious Disorder by Proxy, is a disorder in which a person deliberately causes injury or illness to another person, usually to gain attention or some other benefit. Münchausen by proxy has been described by some as a form of extended...
(MSbP/MSP), which refers to the abuse of another being (typically a child) as a result of having a psychological disorder.
Description
In Munchausen syndrome, the affected person exaggerates or creates
symptomA symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s of
illnessIllness can be defined as a state of poor health. Illness is sometimes considered a synonym for disease. Others maintain that fine distinctions exist...
es in themselves or their child/children in order to gain investigation, treatment, attention, sympathy, and comfort from medical personnel. In some extremes, people suffering from Münchausen's Syndrome are highly knowledgeable about the practice of medicine, and are able to produce symptoms that result in multiple unnecessary operations. For example, they may inject a vein with infected material, causing widespread infection of unknown origin, and as a result cause lengthy and costly medical analysis and prolonged hospital stay. The role of "patient" is a familiar and comforting one, and it fills a psychological need in people with Münchausen's. It is distinct from hypochondriasis in that patients with Münchausen syndrome are aware that they are exaggerating, whereas sufferers of hypochondriasis believe they actually have a disease.
A similar behavior called
Münchausen syndrome by proxyMünchausen syndrome by proxy , referred to in the DSM-IV-TR as Factitious Disorder by Proxy, is a disorder in which a person deliberately causes injury or illness to another person, usually to gain attention or some other benefit. Münchausen by proxy has been described by some as a form of extended...
has been documented in the parent or guardian of a child. The adult ensures that his or her child will experience some medical affliction, therefore compelling the child to suffer treatment for a significant portion of their youth in hospitals. Furthermore, a disease may actually be initiated in the child by the parent or guardian. This condition is considered distinct from Münchausen syndrome.
Origin of the name
The syndrome name derives from
Baron MünchhausenKarl Friedrich Hieronymus, Freiherr von Münchhausen was a German baron born in Bodenwerder, who in his youth was sent to serve as page to Anthony Ulrich II of Brunswick-Wolfenbüttel, and later joined the Russian military...
(Karl Friedrich Hieronymus Freiherr von Münchhausen, 1720-1797) who purportedly told many fantastic and impossible adventures about himself, which Rudolf Raspe later published as
The Surprising Adventures of Baron Münchausen.
In 1951,
Richard AsherRichard Alan John Asher, FRCP was an eminent British Endocrinologist and Haematologist...
was the first to describe a pattern of self-harm, where individuals fabricated histories, signs, and symptoms of illness. Remembering Baron Münchausen, Asher named this condition Münchausen's Syndrome in his article in
The LancetThe Lancet is a peer-reviewed general medical journal, published weekly.One of the world's best-known and most respected general medical journals, with editorial offices in London and New York, The Lancet was founded in 1823 by Thomas Wakley, who named it after the surgical instrument called a...
in February 1951, quoted in his obituary in the British Medical Journal:
Originally, this term was used for all factitious disorders. Now, however, there is considered to be a wide range of factitious disorders, and the diagnosis of "Münchausen syndrome" is reserved for the most severe form, where the simulation of disease is the central activity of the affected person's life.
Treatment and Prognosis
Risk factors for developing Münchausen syndrome include childhood traumas, and growing up with caretakers who, through illness or emotional problems, were unavailable.
Medical professionals suspecting Münchausen's in a patient should first rule out the possibility that the patient does indeed have a disease state, but it is in an early stage and not yet clinically detectable. 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,
mental illnessA mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as part of normal development or culture. The recognition and understanding of mental disorders has changed over time and...
.
Medical providers should consider working with mental health specialists to help treat the underlying mood or disorder as well as to avoid
countertransferenceFirst defined by Sigmund Freud in 1910 in "The Future Prospects of Psycho-Analytic Therapy" as "a result of the patient's influence on [the physician's] unconscious feelings" the topic was left to others to develop as he rarely referred to it himself. . This includes unconscious reactions to a...
. Therapeutic and medical treatment should center on the underlying psychiatric disorder: a
mood disorderA mood disorder is the term given for a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature...
, an
anxiety disorderAnxiety disorder is a blanket term covering several different forms of abnormal and pathological fears and anxieties which only came under the aegis of psychiatry at the very end of the 19th century. Current psychiatric diagnostic criteria recognize a wide variety of anxiety disorders...
or
borderline personality disorderBorderline personality disorder is a psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders that describes a prolonged disturbance of personality function characterized by depth and variability of moods...
. 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 disorderBorderline personality disorder is a psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders that describes a prolonged disturbance of personality function characterized by depth and variability of moods...
, like all personality disorders, is presumed to be pervasive and more stable over time , thus offers the worst prognosis.
If a patient is at risk to himself or herself, inpatient psychiatric hospitalization should be initiated.
Illnesses and conditions commonly feigned by Münchausen patients
- Acid reflux
Gastroesophageal reflux disease ', gastro-oesophageal reflux disease ', gastric reflux disease, or acid reflux disease is defined as chronic symptoms or mucosal damage produced by the abnormal reflux inthe esophagus....
- AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus ....
- Anemia
Anemia is a decrease in normal number of red blood cells or less than the normal quantity of hemoglobin in the blood...
- Anxiety disorder
Anxiety disorder is a blanket term covering several different forms of abnormal and pathological fears and anxieties which only came under the aegis of psychiatry at the very end of the 19th century. Current psychiatric diagnostic criteria recognize a wide variety of anxiety disorders...
- Arthritis
Arthritis is a group of conditions involving damage to the joints of the body....
- Back pain
Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine....
- Bipolar disorder (manic depression)
Bipolar disorder, also known as manic depressive disorder, manic depression or bipolar affective disorder, is a serious mental disorder that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if...
- Cancer
Cancer is a class of diseases in which a group of cells display uncontrolled growth , invasion , and sometimes metastasis...
- Cushing's Syndrome
Cushing's syndrome is a hormone disorder caused by high levels of cortisol in the blood. This can be caused by taking glucocorticoid drugs, or by tumors that produce cortisol or adrenocorticotropic hormone...
- Depression
In psychology and psychiatry, depression is a state of low mood and aversion to activity. While most often described as a disease or dysfunction, there are also strong arguments for seeing depression as an adaptive defense mechanism....
- Dissociative identity disorder
Dissociative identity disorder is a psychiatric diagnosis that describes a condition in which a single person displays multiple distinct identities or personalities , each with its own pattern of perceiving and interacting with the environment...
- Eating Disorders
- Fibromyalgia
Fibromyalgia is also referred to as FM or FMS. Fibromyalgia is characterized by chronic widespread pain and also allodynia, a heightened and painful response to pressure...
- Heart disease
Heart disease or cardiopathy is an umbrella term for a variety for different diseases affecting the heart. As of 2007, it is the leading cause of death in the United States, England, Canada and Wales, killing one person every 34 seconds in the United States alone.-Coronary heart disease:Coronary...
, heart attack
- Immunodeficiency
Immunodeficiency is a state in which the immune system's ability to fight infectious disease is compromised or entirely absent. Most cases of immunodeficiency are acquired but some people are born with defects in the immune system, or primary immunodeficiency...
- Infection
An infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host's resources to multiply, usually at the expense of the host. The infecting organism, or pathogen, interferes with the normal functioning of the...
- Joint pain
- Lupus
Lupus erythematosus is a connective tissue disease. Lupus is a chronic inflammatory disease that occurs when the body's immune system attacks its own tissues and organs. Inflammation caused by lupus can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs...
- Muscle pain
- Migraines
- Kidney disease
Nephrology is a branch of internal medicine and pediatrics dealing with the study of the function and diseases of the kidney.- Scope of the specialty :...
- Post-traumatic stress disorder
Posttraumatic stress disorder is an anxiety disorder that can develop after exposure to one or more traumatic events that threatened or caused great physical harm....
- Pregnancy
Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the uterus of a female. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets. Human pregnancy is the most studied of all mammalian pregnancies. Obstetrics is the surgical field...
- Seizures
- Sexual abuse
Sexual abuse, also referred to as molestation, is the forcing of undesired sexual behavior by one person upon another, when that force falls short of being a sexual assault. The offender is referred to as a sexual abuser or molester...
- Spousal abuse
- Stroke
A stroke is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by thrombosis or embolism or due to a hemorrhage...
- Suicidal ideation
Suicidal Ideation is a common medical term for thoughts about suicide, which may be as detailed as a formulated plan, without the suicidal act itself. Although most people who undergo suicidal ideation do not commit suicide, some go on to make suicide attempts...
or suicide attempt
Patients may have multiple
scarScars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biologic process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound Scars (also...
s on
abdomenIn vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...
due to repeated "
emergencyAn emergency is a situation which poses an immediate risk to health, life, property or environment. Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and agencies may only be able to offer palliative...
"
operationsSurgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance, or sometimes for some other reason...
.
Note that many of these conditions do not have clearly observable or diagnostic symptoms.
See also
- Fabricated or induced illness
- Munchausen Syndrome by Proxy
Münchausen syndrome by proxy , referred to in the DSM-IV-TR as Factitious Disorder by Proxy, is a disorder in which a person deliberately causes injury or illness to another person, usually to gain attention or some other benefit. Münchausen by proxy has been described by some as a form of extended...
- Munchausen by Internet
Münchausen by Internet is a pattern of behavior in which internet users seek attention by feigning illnesses in online venues such as chat rooms, message boards, and Internet Relay Chat . It has been described in medical literature as a manifestation of factitious disorder or factitious disorder by...
- Histrionic personality disorder
Histrionic personality disorder is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness, usually beginning in early adulthood....
- Mythomania
- Psychosomatic illness
Psychosomatic medicine is an interdisciplinary medical field studying the relationships among social, psychological, and behavioral factors and bodily processes in humans and other animals; it is the academic forebear of the modern field of behavioral medicine and a part of the practice of...
External links
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