Mental Health Monday–Munchausen’s Syndrome

Lydia, Sarah, and I are converging to make the perfect storm trifecta of blog posts regarding Munchausen’s Syndrome.

Named after the great Baron von Munchausen, who purportedly told elaborate and fictional stories about himself, Munchausen’s Disorder is part of a class of disorders called Facticious Disorders.

The DSM-IV criteria for Facticious Disorders include:

• Intentionally producing or feigning symptoms of a medical or mental illness
• External motivators (as found in Malingering) (such as wanting three hots and a cot) are absent
• Motivation for such behavior is to adapt the “sick role”

Munchausen Syndrome Factoids:

• Individuals suffering from Munchausen Syndrome have a particularly chronic and severe course
• They tend to have medical knowledge or even training in the medical field
• They will intentionally infect themselves or overdose on medication such that medical intervention is necessary. Examples include: putting urine, feces, or dirty water in a wound; taking insulin to cause a drop in blood sugar; taking Warfarin (Coumadin), a blood thinner, to cause bruising and bleeding
• They will often submit to or even demand invasive procedures and surgeries. A telltale sign of someone with Munchausen’s Syndrome is multiple scars over their bodies, particularly the abdomen
• They will often move from town to town, hospital to hospital, especially when they are “found out”

The risks of having Munchausen’s Syndrome:

• Feigning illness leads to unnecessary and sometimes risky procedures
• Infecting a wound or overdosing on medications could be life-threatening
• A patient often lies about real medical issues or allergies and therefore could be given treatment that will harm or even kill them
• Because of multiple, unnecessary visits to hospitals, they are more at risk of developing iatrogenic illness
• They often refuse corroboration with other treatment providers, leaving gaps in history that may be significant for a clinician to know

So, how do we help people with Munchausen’s Syndrome?

It’s VERY difficult. Most do not admit to their behavior and become very angry when confronted. They sign out AMA (Against Medical Advice) and seek another hospital/clinician. They are often not even remotely interested in psychiatric help. They have little insight (internal understanding) of their illness and behavior. In other words, they aren’t able to see what makes it risky or potentially harmful.

The individual in the photo below had over 40 unnecessary surgeries. Turns out, he did end up developing colon cancer. Talk about the case of the boy who cried wolf!

Remember, these posts are for WRITING PURPOSES ONLY and are NOT to be construed as medical or psychiatric treatment or advice.

ALSO, check out Kendall Grey’s blog today–I’m up for her Manual Transmission tour! 🙂