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Munchausen Syndrome

Alternate Names

  • factitious disorder
  • Munchausen syndrome by proxy
  • MSP

Definition

Munchausen syndrome is a psychiatric disorder in which a person consciously fakes the symptoms of a physical disorder for attention. The person may have many medical tests and surgical procedures before the truth is found out.

What is going on in the body?

A person with Munchausen syndrome fakes or pretends to have symptoms. Sometimes the symptoms are those of a specific illness. In this disorder, the individual fakes symptoms for psychological reasons rather than for financial gain or to get out of responsibilities. The person convincingly presents with intentional symptoms. For example, someone may inject germs into his or her own bloodstreams to cause illness.

Risks

What are the causes and risks of the condition?

The causes of Munchausen syndrome are not well understood. Little is known about its psychological components. Because the person is usually very unwilling to enter any kind of therapy, it is difficult to do research on the disorder.
Some case reports have suggested a history of childhood abuse, combined with frequent illnesses that required hospitalization. Hospitalizations may have been the only time when the child felt safe or nurtured. A person with Munchausen syndrome often describes his or her parents as having been rejecting and distant. A person with Munchausen syndrome seems to be trying to create a nurturing parent-like bond with the healthcare professionals by faking illness.
There is profile of a parent who is likely to have Munchausen syndrome by proxy. These parents are usually mothers and in fact, are often healthcare professionals. They tend to be quite friendly with health professionals and very cooperative with medical procedures. They appear quite concerned about the child, and are sometimes described as overly concerned.

Prevention

What can be done to prevent the condition?

There is no known prevention for Munchausen syndrome. Recognizing MSP can prevent continued abuse. Unnecessary, expensive, and possibly dangerous medical testing can then be avoided.

Diagnosed

How is the condition diagnosed?

This diagnosis of Munchausen syndrome is made when it is certain that there is no organic cause for the person's symptoms. If there is some secondary motive for the person to remain ill, such as the receipt of disability benefits, the person does not meet the definition for Munchausen syndrome. The only motivation for the behavior must be to assume the sick role. When there is a family history of more than one unusual illness or death, MSP should be suspected.

Long Term Effects

What are the long-term effects of the condition?

A person may undergo many unnecessary tests and procedures before Munchausen syndroome is diagnosed.

Other Risks

What are the risks to others?

Munchausen syndrome by proxy can lead to the death of the child.

Treatments

What are the treatments for the condition?

No one treatment has been very effective for Munchausen syndrome. A person with this condition is generally active in seeking treatment for the factitious disorder but usually extremely reluctant to seek treatment for the Munchausen syndrome itself.
Treatment focused on managing Munchausen syndrome, rather than trying to cure it, is more realistic. The aim is to help the person avoid unnecessary, costly, and risky medical procedures. Once Munchausen syndrome by proxy is recognized, the parent needs to be confronted and offered help. Because it is a form of child abuse, MSP must be reported to the authorities. Psychiatric counseling will probably be recommended.

Side Effects

What are the side effects of the treatments?

There are no side effects to treatment.

After Treatment

What happens after treatment for the condition?

No treatment has been shown to be effective. The person may continue to go to different hospitals to prevent suspicion.

Monitor

How is the condition monitored?

A person with Munchausen syndrome is generally unwilling to undergo therapy.

Sources

"Munchausen's syndrome by Proxy", [hyperLink url="http://sids-network.org/msp.htm" linkTitle="sids-network.org/msp.htm"]sids-network.org/msp.htm[/hyperLink]

The Merck Manual of Medical Information, 1997

Current Medical Diagnosis and Treatment, Tierney, 2000

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