Munchausen syndrome (manufacture of disease)

Head | Psychiatry | Munchausen syndrome (manufacture of disease) (Disease)


Description

Munchausen syndrome, a severe and chronic form of factitious disorder, consists of intentional production or feigning of physical symptoms or signs without an external incentive; the motivation for this behavior is to assume the sick role. Symptoms are usually acute, dramatic, and convincing and are accompanied by a tendency to wander from one physician or hospital to another for treatment. The exact cause is unknown, although stress and a severe personality disorder, most often borderline personality disorder, are often implicated.

Causes and Risk factors

Munchausen syndrome is a condition in which a person intentionally fakes, simulates, worsens, or self-induces an injury or illness for the main purpose of being treated like a medical patient. Munchausen syndrome is named after a German military man, Baron von Munchausen, who traveled around telling fantastic tales about his imaginary exploits. In 1951, Richard Asher applied the term to people traveling from hospital to hospital, fabricating various illnesses.

The term Munchausen syndrome is often used interchangeably with factitious disorder. Factitious disorder refers to any illness that is intentionally produced for the main purpose of assuming the sick role, although that purpose is unknown to the sick person. Munchausen syndrome most appropriately describes persons who have a chronic variant of a factitious disorder with mostly physical signs and symptoms, although there are reports in literature regarding psychological Munchausen syndrome, meaning that the simulated symptoms are psychiatric in nature.

Diagnosis and Treatment

Persons with Munchausen syndrome intentionally cause signs and symptoms of an illness or injury by inflicting medical harm to their body, often to the point of having to be hospitalized. These persons are sometimes eager to undergo invasive medical interventions. They are also known to move from doctor to doctor, hospital to hospital, or town to town to find a new audience once they have exhausted the workup and treatment options available in a given medical setting. Persons with Munchausen syndrome may also make false claims about their accomplishments, credentials, relations to famous persons, etc.

Treatment of Munchausen syndrome is often difficult, and there are no standard therapies for the condition. Because people with Munchausen want to be in the sick role, theyre often unwilling to seek treatment. However, if approached in a gentle, face-saving way, a person with Munchausen syndrome may agree to be treated by a mental health provider.

Although there are no standard treatments for Munchausen syndrome, treatment often focuses on managing the condition, rather than trying to cure it. Treatment generally includes psychotherapy and behavior counseling. If possible, family therapy also may be suggested.

Medications may be used to treat other mental d...