Munchausen syndrome (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

Overview

 * Munchausen syndrome is a rare type of mental disorder in which a person fakes illness. The person may lie about symptoms or else produce symptoms using trickery or self-harm. A person with Munchausen syndrome can be very convincing, which results in doctors providing unnecessary treatment including surgery.


 * A person with Munchausen syndrome doesn’t pretend to be ill for personal gain, such as prescription drugs or money. Instead, the person is driven by complex psychiatric reasons, including an abnormal desire for attention and sympathy.


 * This type of mental disorder is most often seen in young adults and is considered a type of self-mutilation. Often a person with Munchausen syndrome is emotionally disturbed from a troubled childhood. Munchausen syndrome is also known as factitious disorder.

What are the symptoms of Munchausen syndrome?
A person with Munchausen syndrome gains intense satisfaction from the attention associated with playing the ill patient or victim. Signs and symptoms that may suggest Munchausen syndrome include:
 * A spectacular medical history that includes a large number of tests, medical procedures and operations
 * Odd collection of seemingly unrelated symptoms
 * No conclusive results despite intense medical investigations
 * New symptoms that appear after medical tests prove negative
 * Extensive medical knowledge of many different illnesses
 * Frequenting many different doctors, sometimes in other states
 * Frequent presentation at emergency departments, usually at different hospitals
 * Requests for invasive medical procedures or surgeries
 * Failure to improve despite medical treatment, including relapsing for unknown reasons.

Who is at highest risk?
Risk factors may include:
 * Chronic illness during childhood – the person may have received a lot of attention because of their illness
 * Chronic illness of a significant family member when the person was a child
 * Self-esteem or identity problems
 * Relationship problems
 * Difficulty distinguishing reality from fantasy
 * Ability to lie and manipulate
 * A history of mental problems such as depression, hallucinations or posttraumatic stress disorder (PTSD)
 * The need to blame personal failures on external factors, such as illness.

Diagnosis

 * Diagnosis is difficult because a range of legitimate physical and mental illnesses must be ruled out first.


 * To complicate matters further, a person with Munchausen syndrome tends to seek help from various health care providers to avoid tipping off any one doctor.


 * Diagnosis, if it happens at all, may depend on abstract concepts such as:
 * The person’s symptoms don’t make sense when compared with the test results.
 * The person is unusually eager to undergo invasive medical procedures and operations.
 * The person doesn’t respond to treatments in a predictable fashion.
 * Other people in the patient’s life don’t confirm the person’s symptoms.

Treatment options

 * Treatment aims to manage rather than cure the condition, but is rarely successful. Recovery tends to be slow or non-existent.


 * Treatment options may include:
 * Medications to treat associated mental disorders such as depression or anxiety. Unfortunately, a person with Munchausen syndrome may misuse prescription drugs to provoke symptoms for further medical intervention.
 * Cognitive behaviour therapy (CBT) may help to change the person’s beliefs and actions. However, the typical person with Munchausen syndrome will never admit to falsifying symptoms, which makes progress difficult. Some patients flatly refuse psychiatric help.
 * Avoiding unnecessary tests and surgeries is important to reduce the risk of complications. However, the typical person with Munchausen syndrome moves on to other doctors and starts the ruse all over again.

Where to find medical care for Munchausen syndrome?
Directions to Hospitals Treating Munchausen syndrome

What to expect (Outlook/Prognosis)?
Recovery is slow or non-existent.

Possible complications
A person with Munchausen syndrome is at risk of many complications including:
 * Side effects from prescription medicines, including overdose
 * Complications from poisoning or self-harm practices
 * Complications from medical procedures or surgeries
 * Death from self-harm or complications of medical intervention.

Source
Better health channel