In Syndromes & Disorders

What Is Munchausen Syndrome?

Munchausen Syndrome

Munchausen syndrome was named after Baron von Munchausen: a German officer in the 18th century who was well-known for embellishing stories about his life experiences. Munchausen syndrome is a type of factitious disorders. Someone who has been diagnosed with Munchausen syndrome repeatedly acts as though they have a physical or mental disorder, when in reality, they don’t. It is important to understand that there is a significant difference between Munchausen syndrome and Munchausen by proxy syndrome.

|SEE ALSO: An Encompassing List of Mental Disorders|

What Is Munchausen Syndrome?

Munchausen syndrome is a mental illness that falls under factitious disorders. Factitious disorders are illnesses that are intentionally produced for the sole purpose of gaining the attention that is associated with being sick, as mentioned in this article on ClevelandClinic.org. Munchausen syndrome is a condition where someone purposely fakes, worsens, self-induces or simulates an illness or injury for the primary purpose of getting treated as a medical patient.

A person with Munchausen syndrome will often go to extremes in their actions. For example, they would be willing to undergo risky and/or painful operations and tests in order to get the special attention that is given to someone who is truly ill. Munchausen syndrome patients will also secretively cause injury to themselves in order to have a notable reason to go to the doctor or hospital. For example, they may seek out ways to cause a sign of blood in their urine, to the extent of cutting themselves in order to have access to blood that they can add to a urine sample.

Symptoms of Munchausen Syndrome

One of the primary symptoms of Munchausen syndrome is the person deliberately producing or exaggerating symptoms in various ways. For example, faking or lying about symptoms, hurting themselves in order to create symptoms and/or altering diagnostic tests. Other warning signs of possible Munchausen syndrome may include:

  • Extensive knowledge of medical terminology, including textbook descriptions of illnesses.
  • A dramatic, but inconsistent medical history.
  • Multiple surgical scars.
  • Extreme eagerness or willingness to have operations, medical tests and procedures.
  • History of seeking treatment at several doctors’ offices, hospitals and clinics. Often times the visits are in different cities.
  • Continual and predictable relapse after improving from a medical condition.
  • Self-esteem and/or identity problems.
  • Reluctance to allow medical professionals to talk with their prior healthcare providers, friends and/or family.
  • Describing new and/or additional symptoms if given negative test results.
  • Symptoms become uncontrollable or more severe if receiving treatment.

Someone with Munchausen syndrome may fake and convince others that they have illnesses, such as cancer, bleeding disorders, cardiac disease, metabolic disorders, skin disorders and a wide range of other non-threatening to life-threatening illnesses.

Causes of Munchausen Syndrome

Although the exact cause of Munchausen syndrome is not known, many researchers and mental health professionals believe that both psychological and biological factors may play a role in its development. Theories suggest a history of neglect or abuse and/or frequent hospitalizations may play a role in the development of the syndrome.

If Munchausen syndrome is suspected, it is extremely important for the person to get treatment. If they are not treated for the condition, it may lead to severe injuries and possibly death. There is treatment available for those with Munchausen syndrome; however, it is intensive and must be followed diligently in order to prevent the risk of a relapse. According to this article on WebMD.com, the only treatment for Munchausen syndrome is psychotherapy, and medications are only prescribed to treat related illnesses, such as depression or anxiety.

What Is Munchausen Syndrome by Proxy?

Munchausen by proxy syndrome (MBPS) is also known as medical child abuse. The term “by proxy” means that a caretaker, either a parent or another adult, either causes real symptoms or makes up fake symptoms to make the child in their care sick or appear to be sick. Munchausen by proxy syndrome is a serious mental illness that often results in the child enduring extreme injuries/illnesses and/or death that is brought on by the caretaker. The victims of MBPS are typically preschoolers and younger; however, there have been cases in children up to the age of 16 and it is seen equally in both boys and girls. This article on MedlinePlus.gov states that Munchausen by proxy syndrome is categorized as a form of child abuse.

The adult purposely misleads medical professionals as well as others outside of the medical profession. The adult may go as far as to deliberately cause symptoms in the child through medications, poisoning and/or suffocation. Usually, the cause is to gain attention and sympathy from medical professionals and other people. Some think that it isn’t only the attention that is gained because of the ill child, but the satisfaction the caretaker has in deceiving others who are considered to be more important than themselves. In some situations, it is thought that the caregiver enjoys the attention they themselves receive for providing care to the “ill child.”

The caregiver typically appears extremely attentive and caring, so it is often difficult for others to suspect there is any wrongdoing. A diagnosis is also often difficult because the caregiver is able to manipulate the medical staff as well as induce varying symptoms in the child. In many situations, the caregiver is medically knowledgeable about various ways of inducing illness and/or impairment in the child. It is often difficult for medical professionals to consider the possibility of Munchausen by proxy syndrome because of their belief that the parent or caregiver would not deliberately cause harm to their child.

Symptoms of MBPS

It is important to note that a diagnosis of MBPS is often extremely difficult. However, some of the signs and symptoms of MBPS typically include:

  • Illness symptoms are short-term and tend to improve or stop when the child is not with the perpetrator. For example, when the child is hospitalized.
  • The child has multiple medical problems and does not respond to treatment or there is a persistent, yet puzzling course of symptoms and illnesses.
  • The caregiver is not “reassured” by the good news when test results do not find any medical problems and continues to believe that the child is ill.
  • The caregiver will “doctor shop” until they find a medical professional who believes them.
  • The caregiver is overly encouraging and supportive of doctors or becomes angry and demands additional intervention, additional procedures, or transfers the child to “more sophisticated” facilities and second opinions.
  • Laboratory or physical examination findings are highly unusual, do not correspond with the medical history of the child or are clinically and/or physically impossible.
  • The caregiver appears to be extremely medically knowledgeable and/or fascinated with medical details.
  • The caregiver seems to enjoy being in a hospital environment and enjoys the attention the child receives for being sick.

In severe situations, caregivers with MBPS will go to great lengths to make the child sick. In cases where cameras are placed in the child’s hospital rooms, the perpetrators have been filmed switching medications, placing drops of blood in urine specimens and/or injecting the child with things such as urine to cause an infection.

Causes of MBPS

Munchausen by proxy syndrome is a serious psychiatric condition. In many of the cases, the perpetrators themselves were physically and/or sexually abused as children and they may have been raised in a family where being sick was a way to get love. The caregivers’ personal needs often overcome their ability to see the child as an individual person who has feelings and rights, which is possibly due to the fact that the caregiver may have grown up being treated as though they were not a person with feelings and/or rights.

In extremely rare cases, Munchausen by proxy syndrome was caused by a medical professional (such as a doctor or nurse) rather than by a family member or caregiver. In this situation, the illnesses are produced by the medical professional during times when the child is being hospitalized for other reasons.

What Happens to the Child?

In many cases of MBPS, hospitalization is required and since the illness/symptoms are typically deemed a medical mystery, the hospital stays are typically longer than usual. Whatever the cause of the illness, the child’s symptoms, whether they are fabricated or created, ease up or completely disappear when the perpetrator is not present. The most common symptoms and/or conditions that are fabricated or created by the caregiver with MBPS typically include asthma, vomiting, failure to thrive, seizures, allergies, diarrhea and/or infections. So, the long term prognosis for the child depends on the amount of damage that has been created by the impairment or illness and the length of time it takes to recognize and diagnose Munchausen by proxy syndrome.

In extreme cases, such as when the child is given poison, urine or forced to undergo multiple surgeries, the child may develop mental retardation, skeletal changes, brain damage, limps problems and/or blindness. If the child survives to be old enough to be able to comprehend what is happening, the psychological damage may be significant. The child may come to believe or feel that the only time they are loved is when they are ill and may help the caregiver attempt to deceive medical professionals and/or use self-abuse in an attempt to avoid the feeling of abandonment. There is also a high risk of the surviving victims of MBPS repeating the cycle of abuse onto others.

Healthcare providers are required by law to report their concerns of suspected MBPS. However, if the caregiver is charged and/or questioned by police about the case, in some situations, the symptoms in the child may increase because the person who is accused will attempt to prove that an illness does really exist. The caregiver may even move to another location and continue the behavior. It is extremely important to get help for both; the victim and the caregiver. However, in order for the caregiver to receive the treatment required, they must admit to the abuse and seek treatment.

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