Munchausen Syndrome (Factious disorder imposed on Self)

When we dive into our childhood memories many of us may recall faking being sick to get out of school or homework. Sometimes we just wanted to sit at home and watch television and pretending to be sick was the easiest way out. But people with Munchausen syndrome pretend to be sick without any apparent reason or gain. Munchausen syndrome is a factitious disorder that is characterised by repeated and elaborate fabrication of clinically convincing physical symptoms and a false medical and social history (American Psychological Association, 2018). People with this rare disorder tend to fake symptoms to gain attention or sympathy. People with this disorder usually have a history of repeated hospitalisation and often may even harm themselves to induce symptoms. (Prakash, et al., 2014)

History Of Munchausen Syndrom

This disorder was named by Richard Asher in 1951 after Baron Münchhausen a German aristocrat who was known for his unbelievable and exaggerated narration of his life and experiences (Asher, 1951). Aster observed a pattern of patients who reported exaggerated symptoms. He also noted that they had believable medical histories and visited countless doctors and hospitals but resisted treatment. Hence, He named this disorder Munchausen syndrome or factitious disorder.

Munchausen Syndrome Vs Munchausen Syndrome By Proxy

Munchausen syndrome or factitious disorder can be classified into two subtypes:

1. Munchausen Syndrome/Factitious Disorder Imposed On Self:

People with Munchausen syndrome pretend to play the “sick role” by falsifying, exaggerating or inducing a medical condition. It is characterized by frequent visits to multiple hospitals and the fabrication of convincing symptoms. The main aim is to fake having an illness to get attention and sympathy sometimes through extreme methods that are harmful to their well-being.

2. Munchausen Syndrome By Proxy/ Factitious Disorder Imposed On Others:

This disorder is characterized by the patient often a caregiver deliberately producing fake symptoms and illness history for their kid or another individual under their care (Sousa Filho, et al., 2017). This condition is usually seen in mothers of small children but fathers and other caregivers can also have it. A person suffering from Munchausen by proxy willingly exposes their kid to potentially harmful procedures and is often linked to child abuse.

Signs and Symptoms

People with Munchausen syndrome may lie or hurt themselves deliberately to bring desired symptoms or tamper with their test results. Important symptoms to consider when diagnosing Munchausen syndrome include:

• Having a long medical history with several different diagnoses.
• Willingness to undergo harmful and painful medical procedures.
• Symptoms that are not improving with diagnosis but often worsen once the treatment starts.
• Presenting vague, exaggerated symptoms surpassing diagnostic criteria.
• Complaining of symptoms inconsistent with test results, which show good health.
• Claiming victimization by healthcare professionals and resisting psychiatric assessments.
• Providing overly detailed and exaggerated medical history narratives.
• Frequent visits to hospitals, switching doctors when no conditions are found.
• Claims of multiple surgeries and serious chronic conditions inconsistent with test results and past consultations.
• Altering medical records and inducing symptoms by poisoning food, using laxatives, or other methods.

Causes

While the exact cause of the disorder is unknown it is usually caused due to a combination of psychosocial factors:

An important risk factor for Munchausen syndrome is childhood trauma. Children who have faced abuse or neglect are at a higher risk of getting Munchausen syndrome. Unresolved parental issues or adverse childhood experiences may drive feigned illness, seeking attention and significance.

Researchers have found a link between personality disorders and Munchausen syndrome. People with antisocial personality disorder, borderline personality disorder and narcissistic personality disorder have a greater chance to develop this disorder. People with personality disorders often have an unstable sense of identity and struggle to form long-lasting and supportive relationships. When they play the “sick role” they gain support and acceptance from people around them encouraging them to continue faking symptoms.

Treatment

It can be extremely difficult to treat Munchausen syndrome as people with this disorder claim to be suffering from a serious physical illness and refuse to cooperate with treatment plans.(Weber, et al, 2023).

• Talk Therapy: Talk therapy has been proven helpful in controlling stress and developing healthier coping skills.
• Medications: Medications may help with comorbid conditions such as depression and anxiety
• Cognitive Behavioural Therapy: CBT can be used to help manage and control the symptoms if the person is willing to accept that they have a problem and cooperates with the treatment.
• Family Therapy: People with Munchausen syndrome who are close to their family may benefit from family therapy. Family discussions can help individuals recognize when they’re adopting the ‘sick role’ and learn strategies to avoid reinforcing such behaviour.
• Creating A Safe Space: Taking a non-judgmental and non-confrontational approach is crucial with Munchausen syndrome patients. Direct accusations could provoke anger and prompt them to seek treatment elsewhere.

In this article, we covered Munchausen syndrome or factitious syndrome imposed on the self, its symptoms, causes and effective treatment methods. It is a very rare psychiatric condition, less than 1 per cent of people in clinical settings will have Munchausen syndrome. (Weber, et al.,2023).Diagnosing this disorder can be challenging as individuals are adept at feigning various diseases and conditions. They may refuse to accept treatment and in severe cases, treatment may not be helpful at all. The most important goal for healthcare professionals is to prevent them from getting more invasive and harmful treatment. It is really important to remember that behind this disorder lies an individual who has suffered a lot and should be provided with support and acceptance through every step of their journey.