Munchausen’s syndrome is a serious mental health disorder. It is named after a German aristocrat, Baron Munchausen, who became famous for telling wild, unbelievable tales about his exploits.
What is Munchausen’s syndrome?
Munchausen syndrome is a type of mental disorder that makes people claim they are sick when they are not. The condition has been linked to severe emotional difficulties. Most of the fake symptoms like chest pain, stomach problems, or fever, tend to be linked to physical illnesses. Their main intention is to assume the “sick role” so that people care for them and they are the centre of attention.
Any practical benefit in pretending to be sick – for example, claiming incapacity benefit – is not the reason for their behaviour.
Some people with Munchausen’s syndrome may spend years travelling from hospital to hospital faking a wide range of illnesses. When it’s discovered they are lying, they may suddenly leave hospital and move to another area. They might also go to several doctors as well.
People with Munchausen’s syndrome can be very manipulative and, in the most serious cases, may undergo painful and sometimes life-threatening surgery, even though they know it is unnecessary.
Who presents with Munchausen’s syndrome?
There appear to be 2 separate groups of people affected by Munchausen’s syndrome. They are:
• women who are 20 to 40 years of age, often with a background in healthcare
• unmarried white men who are 30 to 50 years of age
It is unclear why these two groups tend to be affected by Munchausen’s syndrome.
Other individuals might also present with this syndrome.
Some experts believe Munchausen’s syndrome is underdiagnosed because many people succeed in deceiving medical staff.
What Are the Symptoms of Munchausen Syndrome?
People with Munchausen syndrome deliberately produce or exaggerate symptoms in several ways. They may lie about or fake symptoms, hurt themselves to bring on symptoms, or alter tests (such as contaminating a urine sample). Possible warning signs of Munchausen syndrome include:
• 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 with others or 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 doctors to meet with or talk to family, friends, or prior doctors
• Problems with identity and self-esteem
• Reduce size
What causes Munchausen’s syndrome?
Munchausen’s syndrome is complex and poorly understood disorder. Many people refuse psychiatric treatment or psychological profiling, and it is unclear why people with the syndrome behave the way they do.
Several factors have been identified as possible causes of Munchausen’s syndrome and include the following:
• emotional trauma or illness during childhood – this often resulted in extensive medical attention
• a personality disorder – a mental health condition that causes patterns of abnormal thinking and behaviour
• a grudge against authority figures or healthcare professionals
Diagnosing Munchausen’s syndrome
Diagnosing Munchausen’s syndrome can be challenging for medical professionals.
People with the syndrome are often very convincing and skilled at manipulating and exploiting doctors.
If a healthcare professional suspects a person may have Munchausen’s syndrome, they should look at the person’s health records to check for inconsistencies between his/her claimed and actual medical history.
Healthcare professionals can also run tests to check for evidence of self-inflicted illness or tampering with clinical tests.
Doctors will also want to rule out other possible motivations for their behaviour, such as faking illness for financial gain or because they want access to strong painkillers.
Munchausen’s syndrome can usually be diagnosed if:
• there’s clear evidence of fabricating or inducing symptoms
• the person’s prime motivation is to be seen as sick
• there’s no other likely reason or explanation for his/her behaviour
Treatment
Although a person with Munchausen syndrome actively seeks treatment for the various disorders he or she invents, the person is often 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.
Treatment involves trying to modify the individual’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 may be causing the person’s behavior. Another key goal is to help patients avoid dangerous and unnecessary medical diagnostic or treatment procedures (such as surgeries), often sought from different doctors who may be unaware that physical symptoms are either being faked or self-inflicted.
In most cases, the disorder is a chronic, or long-term, condition that can be very difficult to treat.
There is no known way to prevent this disorder. However, it might be helpful to begin treatment in people as soon as they begin to have symptoms.
Conclusion
Munchausen syndrome is a mental disorder in which the patient fakes illness to gain attention and sympathy. Munchausen syndrome is a mental illness associated with severe emotional difficulties. Some people will suffer only a single episode of symptoms. In most cases, however, the disorder is a recurring condition that can be very difficult to treat. Many will deny they are faking symptoms and will not seek or follow treatment.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
