Munchausen (MOON-chow-zun) syndrome is a serious mental disorder in which someone with a deep need for attention pretends to be sick or gets sick or injured on purpose. People with Munchausen syndrome may make up symptoms, push for risky operations, or try to rig laboratory test results to try to win sympathy and concern.
Munchausen syndrome belongs to a group of conditions, called factitious disorders, that are either made up or self-inflicted. Factitious disorders can be psychological or physical. Munchausen syndrome refers to the most severe and chronic physical form of factitious disorder.
Munchausen syndrome is a mysterious and hard to treat disorder. However, medical help is critical for preventing serious injury and even death caused by the self-harm typical of Munchausen syndrome.
Munchausen syndrome symptoms revolve around faking or producing illness or injury in order to meet deep emotional needs. People with Munchausen syndrome go to great lengths to avoid discovery of their deception, so it may be difficult to notice that their symptoms are actually part of a serious mental disorder.
Munchausen syndrome is not the same as inventing medical problems for practical benefit, such as getting out of work or winning a lawsuit. It also isn't the same as hypochondria. People with hypochondria truly believe they are sick, whereas people with Munchausen syndrome aren't sick, but they want to be.
In Munchausen syndrome by proxy, someone makes another person ill in order to win sympathy. Usually, Munchausen syndrome by proxy involves a parent harming a child.
Munchausen syndrome symptoms may include:
How those with Munchausen syndrome fake illness
People with Munchausen syndrome make up symptoms or cause illness in several ways, including:
When to see a doctor
If you think a loved one may be exaggerating or faking his or her health problems, it may help to attempt a gentle conversation about your concerns. Try to avoid anger, judgment or confrontation. Offer support and caring and, if possible, help in finding treatment.
The cause of Munchausen syndrome is unknown. However, people with this disorder may have experienced a severe illness when they were young, or may have been emotionally or physically abused.
Several factors may put someone at higher risk of developing Munchausen syndrome, including:
Munchausen syndrome is considered rare, but it's not known how many people have the disorder. Some people use fake names to avoid detection, some visit many different hospitals and doctors, and some are never found out — all of which make it difficult to make a reliable estimate.
More males are diagnosed with Munchausen, and it seems to be more common among young or middle-aged adults.
People with Munchausen syndrome have such deep emotional needs that they're willing to risk their lives to be seen as sick. They frequently have other mental disorders, as well. As a result, they face many possible complications, including:
Preparing for your appointment
A person with Munchausen syndrome is likely to first receive care for this condition when a doctor raises concerns that psychological problems may be a factor in his or her illness. If your loved one has symptoms that suggest Munchausen syndrome, his or her doctor may contact you in advance to talk about your loved one's health history.
If you think a loved one may have Munchausen syndrome, contact his or her doctor and start the conversation yourself.
Here's some information to help you get ready for that talk.
What you can do
For Munchausen syndrome, some questions to ask the doctor include:
What to expect from your doctor
What you can do in the meantime
If your loved one causes self-inflicted injury or tries to commit suicide, call 911 or emergency medical help, or take him or her to an emergency room immediately.
Tests and diagnosis
Diagnosing Munchausen syndrome is often extremely difficult. People with Munchausen are experts at faking many different diseases and conditions. And often they do have real and even life-threatening medical conditions, even though these conditions may be self-inflicted.
A health care professional who suspects Munchausen syndrome may check medical records, try to talk to family or friends, or even search the person's hospital room for injected materials or hidden medications, although this raises ethical concerns.
Direct accusations of Munchausen syndrome are likely to make the affected person angry and defensive, causing him or her to abruptly end a relationship with a doctor or hospital and seek treatment elsewhere. So your loved one's doctor is likely to try to create an "out" that spares your loved one the humiliation of admitting to faking symptoms.
For example, the doctor may reassure your loved one that not having an explanation for medical symptoms is legitimately stressful and suggest that the stress may in fact be responsible for some physical complaints. Or, the doctor may ask your loved one to agree that, if the next one or two medical treatments don't work, they will explore together the idea that there may be a psychological cause for the illness. Either way, the doctor will try to steer your loved one toward care with a mental health provider.
Munchausen syndrome is diagnosed as a type of factitious disorder. To help determine if someone has Munchausen syndrome, mental health providers conduct a detailed interview and also run tests for possible physical problems.
To be diagnosed with factitious disorder, someone must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association.
For factitious disorder to be diagnosed, three criteria must be met, including:
Treatments and drugs
Treatment of Munchausen syndrome is often difficult, and there are no standard therapies for the condition. Because people with Munchausen want to be in the sick role, they're often unwilling to seek treatment. However, if approached in a gentle, face-saving way, a person with Munchausen syndrome may agree to be treated by a mental health provider.
Although there are no standard treatments for Munchausen syndrome, treatment often focuses on managing the condition, rather than trying to cure it. Treatment generally includes psychotherapy and behavior counseling. If possible, family therapy also may be suggested.
Medications may be used to treat other mental disorders that also are present, such as depression or anxiety. In severe cases, temporary psychiatric hospitalization may be necessary.
Lifestyle and home remedies
Overcoming Munchausen syndrome can be difficult. For those who are able to begin taking steps toward managing this condition, these tips may help:
Because the cause of Munchausen syndrome is unknown, there's currently no known way to prevent the disorder. However, if your child is being treated for a serious illness, be careful not to overemphasize his or her role as a sick person or your role as a caretaker.
Talk with your child's doctor about setting reasonable expectations for what your child can accomplish, both mentally and physically, and support your child in succeeding at these tasks independently. Taking this approach may help foster your child's long-term mental health.
Last Updated: 2011-05-13
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