Munchausen syndrome: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Munchhausen's syndrome - a severe and chronic form of imitation of the disease - consists in the repeated production of false physical symptoms in the absence of external benefit; the motivation for this behavior is to assume the role of the patient. Symptoms are usually acute, vivid, convincing and are accompanied by a transition from one doctor or hospital to another. The exact cause is unknown, although stress and borderline personality disorder usually matter.
Symptoms of Munchausen's syndrome
Patients with Munchausen's syndrome can simulate many physical symptoms and conditions (eg, myocardial infarction, hemoptysis, diarrhea, fever of unclear etiology). The abdomen of the patient may be scarred or the finger or limb may be removed. Fever is often the result of self-injection of injections with bacteria; often an infectious agent is Escherichia coii. Patients with Munchausen syndrome sometimes endlessly make up problems for somatic or surgical clinics. However, this disorder is a mental problem, more complex than just a fraudulent simulation of symptoms, and is associated with severe emotional problems. Patients may display signs of a hysteroid or borderline personality disorder, but they are usually smart and inventive. They know how to feign disease, and are aware of the issues of medical practice. They differ from the simulators, because although their deception and simulation are deliberate and deliberate, their benefit is not clear, apart from the medical attention to their illness, their motivation and search for attention are largely unconscious and hidden.
Patients could suffer emotional or physical violence at an early age. They also could endure a serious illness in childhood or have seriously ill relatives. The patient gives the impression of having problems with one's own identity, inadequate control of impulsiveness, a lack of a sense of reality, an unstable relationship. A false disease can be a way to increase or defend self-esteem by censuring the failure of specialists in recognizing their illness, which is often associated with observation by prestigious doctors and large medical centers, and presenting themselves in the unique, heroic role of a knowledgeable and experienced person in medicine.
The diagnosis is based on anamnesis and examination, which includes the examinations necessary to eliminate somatic diseases. Less severe and chronic forms of imitating the disorder may also include the production of physical symptoms. Other forms of imitation of the disorder may include simulating mental (rather than physical) signs and symptoms, such as depression, hallucinations, delusions, or symptoms of post-traumatic stress disorder. In these cases, the patient also assumes the role of patient.
In other cases, patients can produce both mental and physical symptoms.
Munchhausen syndrome by proxy
Munchhausen's proxy syndrome is an option in which adults (usually parents) deliberately induce or mimic the symptoms of a person who is under their care (usually a child).
Adults falsify the anamnesis and can inflict damage on the child with medication or other methods or add blood and bacterial contamination to the urinalysis to simulate the disease. The parent seeks medical care for the child and seems deeply troubled and protective. In the history of the child, there are frequent hospitalizations, usually in connection with a variety of nonspecific symptoms, but in the absence of an accurate diagnosis. Child victims can be seriously ill and sometimes die.
Treatment of Munchausen's syndrome
Treatment of Munchausen's syndrome is rarely successful. Patients are initially relieved when their treatment requirements are met, but their discontent tends to intensify, eventually they tell the doctor what they must do. Confronting or refusing to meet treatment requirements usually leads to angry reactions, and the patient usually goes to another doctor or to another hospital. The patient usually refuses from psychiatric treatment or tries to go for cunning, but consultation and subsequent help can be taken at least with the purpose of helping in resolving the crisis. However, patient management is usually limited to early recognition of the disorder and prevention of risky procedures and excessive or misuse of drugs.
Patients with Munchausen's syndrome or with more limited simulated disorders need to be non-aggressive and non-indicative to contrast their diagnosis without causing guilt or reproaches by identifying this condition as a cry for help. Alternatively, some experts recommend a non-confrontational approach that offers patients a way to recover from their illness without assuming their role as the cause of the disease. In both cases it is useful to pursue the idea that the doctor and patient can jointly solve this problem.