What is Munchausen syndrome?
Munchausen syndrome—named for Baron von Munchausen, an 18th century German officer who was known for embellishing the stories of his life and experiences—is the most severe type of factitious disorder. Most symptoms in people with Munchausen syndrome are related to physical illness—symptoms such as chest pain, stomach problems, or fever—rather than those of a mental disorder.
Munchausen syndrome is a type of factitious disorder or psychiatric disorder, in which a person repeatedly acts as if he or she has a physical or mental disorder when, in truth, he or she has caused the symptoms by himself or herself. It is also known as hospital addiction syndrome or hospital hopper syndrome.
The patients often tend to get sympathy and special attention as given to people who are truly ill. They can injure themselves to cause signs like vomiting blood, blood in the urine or cyanosis of a limb. Munchausen syndrome is a mental illness associated with severe emotional difficulties.
What are the symptoms of Munchausen syndrome?
Warning signs of Munchausen syndrome include the following:
- Dramatic but inconsistent medical history
- Unclear symptoms that are not controllable and that become more severe or change once treatment has begun
- Predictable relapses following improvement in the condition
- Extensive knowledge of hospitals and/or medical terminology, as well as the textbook descriptions of illnesses
- Presence of multiple surgical scars
- Appearance of new or additional symptoms following negative test results
- Presence of symptoms only when the patient is alone or not being observed
- Willingness or eagerness to have medical tests, operations, or other procedures
- History of seeking treatment at numerous hospitals, clinics, and doctors’ offices, possibly even in different cities
- Reluctance by the patient to allow health care professionals to meet with or talk to family, friends, or prior health care providers
- Problems with identity and self-esteem
- More comfortable being in the hospital than you might think
- Medical knowledge may be quite extensive from many hospitalizations or prior work
What causes Munchausen syndrome?
The exact cause of Munchausen syndrome is not known, but researchers believe both biological and psychological factors play a role in the development of this syndrome. Some theories suggest that a history of abuse or neglect as a child, or a history of frequent illnesses requiring hospitalization, might be factors associated with the development of this syndrome.
How is Munchausen syndrome diagnosed?
Diagnosing Munchausen syndrome is very difficult because of the dishonesty that is involved. Doctors must rule out any possible physical and mental illnesses, and often use a variety of diagnostic tests and procedures before considering a diagnosis of Munchausen syndrome.
If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist — mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use a thorough medical history and physical, laboratory imagery, and psychological assessment tools to evaluate a person for Munchausen syndrome. The doctor bases his or her diagnosis on the exclusion of actual physical or other psychiatric disorders, and his or her observation of the patient’s attitude and behavior.
How is Munchausen syndrome treated?
Although a person with Munchausen syndrome actively seeks treatment for the various disorders he or she invents, the person often is unwilling to admit to and seek treatment for the syndrome itself. This makes treating people with Munchausen syndrome very challenging, and the outlook for recovery poor. If caretakers can protect the patient from self-harm and educate him or her about consequences that can occur, it may be helpful. Trying to reduce his or her care through only one physician, or two working closely together (psychiatrist and internist), is also suggested.
When treatment is sought, the first goal is to modify the person’s behavior and reduce his or her misuse or overuse of medical resources. Once this goal is met, treatment aims to work out any underlying psychological issues that might be causing the person’s behavior or help him or her find solutions to housing or other social needs.
As with other factitious disorders, the primary treatment for Munchausen syndrome is psychotherapy. Treatment likely will focus on changing the thinking and behavior of the individual (cognitive-behavioral therapy). Family therapy also might be helpful.
There are no medicines to treat factitious disorders themselves. Medicine might be used, however, to treat any related disorder—such as depression, anxiety, or a personality disorder. The use of medicines must be carefully monitored in people with factitious disorders due to the risk that the drugs might never be taken up from the pharmacy or might be used in a harmful way.