What Is Munchausen Syndrome?
Munchausen syndrome is a psychological disorder where a person pretends to be ill or fakes symptoms of illness to gain attention and care from people. This syndrome was named after the German aristocrat Baron Munchausen who was well known for delivering unbelievable tales of his exploits. Presently Munchausen syndrome is termed a factitious disorder imposed on another (FDIA). In the case of FDIA, an individual lies about the illness of the dependent person, like children or old adults though they are completely fine. Munchausen syndrome is considered a psychological disorder as it presents with emotional difficulties. This condition is considered harmful as a person has to undergo many tests, though he is fine. Multiple medical visits and tests are a waste of time and resources, and being on medications, though unnecessary, can have adverse effects on the body.
What Are the Symptoms of Munchausen Syndrome?
People with Munchausen syndrome present with the following symptoms:
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Frequent Lying About the Symptoms: These people choose symptoms that are difficult to disapprove of and continue to lie about them to seek attention. They state they have headaches or pretend to pass out.
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Alter the Test Reports: People with Munchausen syndrome try to tamper with the samples presented or change the reports submitted by the lab; they may heat the thermometer to show they have a high fever or add blood to the urine sample.
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Self-Infliction: Subjects try to cause harm to themselves to be the center of attention. To gain attention and care, they can go up to any extent and try to cut, burn, poison themselves, or have contaminated food.
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Aggravating Conditions: They even try to avoid healing or getting better when ill. For example, people with Munchausen syndrome try to reopen healed wounds and avoid taking medications when sick.
What Are the Causes of Munchausen Syndrome?
Various factors contribute to the development of the disorder, which include:
1) Emotional Trauma or Abuse During Childhood:
It has been evident that Munchausen syndrome has an association with childhood trauma. Children with unresolved issues with their parents tend to punish themselves as they feel unworthy; they do so to gain attention and need to pass the responsibility of their care to other people. It has also been evident that children who had extensive medical procedures during childhood develop the habit of being cared for and expect the same when they grow up as adults; thus, they pretend to be ill to seek similar attention.
2) Personality Disorder- A psychological condition that is characterized by abnormal thinking patterns. People with personality disorders do not have a sense of their identity and lack attention due to their inability to form meaningful relationships with others.
Some of the disorders are:
3) Antisocial personality disorder: to seek pleasure, individuals deceive doctors; by doing this, they feel powerful.
4) Borderline Personality Disorder: Characterized by vague feelings, a person struggles between the positive and negative emotions of others.
5) Narcissistic Personality Disorder: People are confused about their thoughts about themselves as they feel important and worthless all at once. These people pretend to be ill to gain support and acceptance from others.
6) Grudges Against Healthcare Professionals and System
How Is Munchausen Syndrome Diagnosed?
Diagnosis of Munchausen syndrome can be challenging for the physician as the patient is skilled in faking the symptoms.
To proceed and reach an accurate diagnosis physician must do the following:
Previous Medical Records: Patients' previous records are checked to determine the inconsistency between the patient's statement and the disease. Can carry out Investigations to know if the patient is faking illness or if any traces of self-inflicting disorder are found, like blood tests to find traces of drugs that are not prescribed and can cause symptoms. In addition, leading questions can be asked to determine if the patient is faking illness for external gains, like having drugs that they are addicted to.
The diagnosis of Munchausen's syndrome can usually be confirmed if:
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The symptoms are being faked.
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The patient seems to crave attention and feels better when someone sympathizes with them.
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No specific medical diagnosis is evident in the lab reports.
Munchausen syndrome is commonly seen in:
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Females with a medical background between the age of 20-40.
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Unmarried white male between the age of 30-40.
The reason for predilection in both remains unknown.
How Is Munchausen Syndrome Treated?
Treating Munchausen's syndrome has proved difficult for the physician as the patient is very good at pretending and presents with illnesses that usually are difficult to diagnose, like headaches. There have been different schools of thought that debate the factors that the syndrome should be confronted by the patient or not. Some believe it should not be confronted, and the patient should be referred to a psychiatrist. Others believe in straightforward questioning of the reason for telling lies. The other fact that makes treatment difficult is the disbelief of the patient; the patient is reluctant to accept that he has any mental disorder and refuses treatment. In the case of Munchausen syndrome, the best thing to be done is a referral provided to a psychiatrist, as the doctor-patient relationship is entirely based on trust.
1) Psychiatric Treatment and Cognitive-Behavioral Therapy:
Any framed treatment plan is unavailable to treat Munchausen syndrome, but it has been reported that the patients recover after a combination therapy of psychoanalysis and cognitive behavioral therapy. For any treatment to work efficiently, the patient's acceptance of the disorder and cooperation is essential. Psychoanalysis and cognitive-behavioral therapies aim to alter an individual's thought process and make him understand the thoughts possessed are unrealistic.
2) Family Therapy
Family therapy can prove very effective as a person spends most of the time with the family and his motive is attention and care-seeking. Thus families can try to make a person understand how it affects family members. Whenever the family members are confident that the patient is faking symptoms, he must not be given attention; if the purpose of faking illness is not achieved, there is a possibility that after a while, the person realizes this is ineffective and stops faking illness.
Conclusion:
Munchausen syndrome is a psychological disorder where a person is used to faking illness to gain attention and care. These are usually developed in children who have been abused or ignored as a child, most commonly diagnosed in females with a healthcare background and white unmarried men. Diagnosis is difficult as the patient is very good at pretending. Such cases, if left undiagnosed, end up wasting a lot of time and medical resources. Treatment is usually tricky and has a multifactorial approach; psychotherapy and family therapy can prove helpful.
