Munchausen syndrome is a factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves. Munchausen syndrome fits within the subclass of factitious disorder with predominantly physical signs and symptoms, but patients also have a history of recurrent hospitalization, travelling, and dramatic, extremely improbable tales of their past experiences. The condition derives its name from Baron Munchausen.
There is discussion to reclassify them as somatoform disorders in the DSM-5 as it is unclear whether or not people are conscious of drawing attention to themselves. In the current iteration, the term “somatoform disorder” (as used in the DSM-IV-TR and other literature) is no longer in use; that particular section of the DSM-5 has been renamed “somatic symptom and related disorders”. Officially, Munchausen syndrome has been renamed “factitious disorder”, with specificity either as “imposed on self” or “imposed on another” (formerly “by proxy”).
Munchausen syndrome is related to Munchausen syndrome by proxy (MSbP/MSP), which refers to the abuse of another person, typically a child, in order to seek attention or sympathy for the abuser. This drive to create symptoms for the victim can result in unnecessary and costly diagnostic or corrective procedures.
Signs and symptoms
In Munchausen syndrome, the affected person exaggerates or creates symptoms of illnesses in themselves to gain examination, treatment, attention, sympathy, and/or comfort from medical personnel. In some extreme cases, people suffering from Munchausen syndrome are highly knowledgeable about the practice of medicine and are able to produce symptoms that result in lengthy and costly medical analysis, prolonged hospital stays, and unnecessary operations. The role of “patient” is a familiar and comforting one, and it fills a psychological need in people with this syndrome. This disorder is distinct from hypochondriasis and other somatoform disorders in that those with the latter do not intentionally produce their somatic symptoms. Munchausen syndrome is distinct from other psychiatric disorders such as malingering in that Munchausen does not fabricate symptoms for material gain such as financial compensation, absence from work, or access to drugs.
Risk factors for developing Munchausen syndrome include childhood traumas, growing up with parents/caretakers who were emotionally unavailable due to illness or emotional problems, a serious illness as a child, failed aspirations to work in the medical field, personality disorders, and low self-esteem. Munchausen syndrome is more common in men and is seen in young or middle-aged adults. Those with a history of working in healthcare are also at greater risk of developing it.
Arrhythmogenic Munchausen syndrome describes individuals who simulate or stimulate cardiac arrhythmias to gain medical attention.
A similar behavior called Munchausen syndrome by proxy has been documented in the parent or guardian of a child. The adult ensures that his or her child will experience some medical affliction, therefore compelling the child to suffer through treatments and spend a significant portion of their youth in hospitals. Furthermore, a disease may actually be initiated in the child by the parent or guardian. This condition is considered distinct from Munchausen syndrome. There is growing consensus in the pediatric community that this disorder should be renamed “medical abuse” to highlight the harm caused by the deception and to make it less likely that a perpetrator can use a psychiatric defense when harm is done.
Diagnosing Munchausen syndrome requires a clinical assessment. Clinicians should be aware that patients (or persons reporting for patients) may malinger, and caution should be taken to ensure there is evidence for a diagnosis. Lab tests may be required, including complete blood count (CBC), urine toxicology, drug levels from blood, cultures, coagulation tests, assays for thyroid function, or DNA typing. In some cases CT scan, magnetic resonance imaging, psychological testing, electroencephalography, or electrocardiography may also be employed.
Content retrieved from: https://en.wikipedia.org/wiki/Munchausen_syndrome.