What is Munchausen Syndrome?
Munchausen syndrome is a factitious psychological disorder, in which affected individual deliberately pertaining that he/she has an illness. Therefore, Munchausen syndrome is a disease, where patient plays a “sick role”, as he or she wants people should care him or her and he/she will be the center of attention. However, the practically affected individual does not have any physical illness or mental disorder. Therefore, this Munchausen syndrome is a specific type of psychological disorder, in which emotional problems are the main outcome of this condition.
In the 18th century, Baron von Munchausen was a German aristocrat first described stories about his life, in which they explained his experiences about the severe type of factitious disorder. Munchausen syndrome is named after his name.
Munchausen syndrome affected patients mostly complain several physical symptoms, including chest pain, fever, a stomach disorder. Therefore, the characteristic feature of Munchausen syndrome is a factitious psychological disorder with some extent physical symptoms1,2.
Types of behaviour
Munchausen syndrome affected patients do not represent same behavior, but their activities varies in different ways, which include
- Act as if they have psychological symptoms – for example, claim to see someone or some things which practically not present on that site or claim to listen to the voice that is not really there
- Presence of imaginary physical symptoms – for example, claim to have stomach ache or chest pain
- Aggressively tiresome to get ill – such as intentionally infecting a lesion by purposefully contacting dirt into it
Some individuals having Munchausen syndrome may spend years for traveling from hospital to hospital pretending a broad range of illnesses. after the discovery of no illness in patients with Munchausen syndrome may unexpectedly disappear from the hospital and search for new areas. Some patients are so desperate that they can even perform the unnecessary surgical process2.
Munchausen syndrome affected individuals intentionally create or overstate symptoms in many different ways. They may act falsely to show their fake symptoms. Even patients are so much deliberate that they hurt themselves to get symptoms or aggravate mild symptoms. Sometimes they alter sample to bring serious tests report like consciously contaminate urine sample. The following are possible signs of Munchausen syndrome:
- Pretentious but not consistent medical history
- Uncontrolled, indistinguishable symptoms and after treatment started the symptoms are not abolished but become more severe
- Unpredictable reoccurring symptoms with unexplained improvement
- Depth knowledge about the diseases, healthcare system
- Multiple intervening wound marks in the body
- Every visit in hospital generates new symptoms, which do not provide any relevant test result or tests reports provide negative report
- Symptoms only appear in presence of others or being noticed
- Readily willing to perform medical tests, surgical procedure or other critical procedure
- Individual have medical history to visit several clinics, hospitals for seeking treatment, even they visit many places for treatment purpose
- Patients show unwillingness or do not allow doctor to meet or discuss his/her condition with family members1,3,4
The exact cause of Munchausen syndrome is not understood, as affected patients do not ready to perform detail psychological profiling. Experts believe both physical and psychological factors are involved in developing this syndrome. Some psychologist believes that history of child abusing or negligence in childhood or frequent hospitalization due to illness at a younger age may influence the onset of Munchausen syndrome. Experts also found an association between personality disorders and Munchausen syndrome3,4.
How common is it?
Yet now no statistical data about the prevalence of the disorder is achieved from a reliable source, therefore it is difficult to estimate the exact incidence rate of this disease. However, hospital data does not show a frequent medical record about Munchausen syndrome and it has been considered that Munchausen syndrome is a rare disorder. Only 1% of hospital visit may meet the symptomatic criteria1,2.
The case study analysis showed that Munchausen syndrome usually affects two groups of people, they are
- Women with a with a background in healthcare, including nursing staff or other para-medical staffs. The onset of the syndrome occur at the age between 20 to 40 years
- White race unmarried men with age between 30 to 50 years5.
Munchausen syndrome diagnosis is a challenging job for medical professionals, as affected individuals tell lie about their symptoms and also have knowledge about manipulating their test reports. A health care professional should thoroughly check the medical history of the patient and detail findings of symptomatic approaches are important to diagnose the Munchausen syndrome.
Findings of following criteria usually make sure about the patient is having Munchausen syndrome: a clear indication of inducing or fabricate symptoms, patiently try to pretentious to become sick, No explanation about their behavior3,5.
The management of the patients with Munchausen syndrome is difficult, as this is a chronic condition. Patients also do not want to cure themselves and try to escape from proper treatment procedure. The main aim of the treatment to avoid all the provocations, which trigger patient to react more to become the center of attention.
It is very necessary to balancing the emotional and psychological balancing. This can be achieved by providing supportive behavior to the patients and for this, both healthcare providers and family member and relatives should concern about the patient condition. Following are some treatment approaches for Munchausen syndrome:
Psychiatric treatment and CBT
It is often common that patient with Munchausen syndrome has a problem to co-operates with treatment. Yet now no established treatment is available for treating patients with Munchausen syndrome. But clinicians get a good result with a combination of psychoanalysis and cognitive behavioral therapy (CBT).
It has been found that unconscious thought process and drives can be uncovered through psychoanalysis and disclosing these can help to treat the patient. Along with this CBT assists in identifying the uncooperative and impractical beliefs and behavioral patterns. Proper therapeutic approaches can assist in balancing the psychological and emotional balancing.
Munchausen syndrome affected individual also need family support. Family therapy mainly concerns about the detection of conditions or behavior or belief which negatively impacted on patient behavior and require to avoid them. Supportive behavior offering good result1,3,4,5.
Munchausen syndrome provides a negative impact on the overall life of the affected individual. It increases the overall healthcare cost due to performing unnecessary tests and medical consultation without the presence of any specific disease, which may cause an economic burden on the patient or their family. Self-harming and suicidal nature can cause a serious problem.
Approximately, 30%-70% of cases symptoms become worse due to aggravated nature of the patient. Male affected patients tend to be more aggressive than females, and outcome of the condition is worsened if the patient still abusing or victimized. Poor prognosis is also observed in association with other mental disorders. The proper treatment of associated psychological disorder can improve the prognosis of the Munchausen syndrome4,5.
- Munchausen Syndrome – http://www.webmd.com/mental-health/munchausen-syndrome#1
- Munchausen syndrome – http://my.clevelandclinic.org/health/articles/munchausen-syndrome