Münchhausen syndrome: causes, symptoms and treatment

Why do some people feign illness?

Baron von Münchhausen, a German baron who served in the service of Antony Ulrich II and later enlisted in the Russian army, lends his name to this disturbing syndrome because the baron, upon returning to his birthplace, told far-fetched and fabricated stories about his adventures away from home, including riding on a cannonball and going to the moon.

One of the first cases of Münchhausen SyndromeSyndrome, which has gained some popularity due to its appearance in the series House, but which is, after all, a completely real phenomenon.

What is Münchhausen Syndrome?

This factitious disorder consists of a constant and intentional simulation of illnesses, usually very convincing and spectacular. To this end, the patient may self-injure, ingest toxic substances and even self-inject bacteria such as Escherichia coli. The affected person has the motivation to assume the role of the sick person and to feel cared for and cared for..

This mental disorder usually begins in early adulthood, is more common among men and especially among people working in a medical service environment, many of whom have knowledge and an ability to access materials that facilitates the reproduction of the syndrome.

Symptoms of Münchhausen Syndrome

Symptoms are limited by the patient's knowledge or fantasy.. Although these are very varied, the most common are allergic reactions, Respiratory problems, convulsions, diarrhea, fever, fainting, vomiting, and even hydroelectric disorders. In addition, people with Münchhausen syndrome also often require large doses of painkillers and narcotics.

Patients with Münchhausen Syndrome often visit different hospitals complaining of the same complaints they have described in the previous hospital they visited; moreover, their medical knowledge and the accuracy in the representation of their symptoms make it necessary for doctors to repeatedly perform different tests and diagnostic methods on them. They never object to any test, no matter how painful it may be, and they are particularly they are particularly submissive when they are hospitalized in a health center..

This disorder can be of different intensity depending on the person affected. For example, in Cuba, severe cases have been described in which the patient has even inoculated himself with the HIV virus.

Characteristics and basic signs

Münchhausen's disease can be described in the following points:

• Constant search for the sick role.
• Self-injury and self-administration of medication to cause symptoms that may have the appearance of credibility.
• Very repeated attendance to hospitals.
• Aggressive behavior when blamed for simulating symptoms or when a doctor refuses to do any test (even if unnecessary).
• High knowledge of medical concepts.

Diagnosis

The diagnosis of the Münchhausen's disease is based on the elimination of other psychiatric syndromes once it has been detected that the patient has such a disorder..

On the one hand, medical specialists must rule out other pathologies with very similar characteristics, such as somatization disorder, where there are physical symptoms without a medical illness to explain them. The main difference between somatization disorder and Münchhausen Syndrome is that in the former there is a real physical symptomatology, although of unknown origin.

On the other hand, the hypochondriac patient exaggerates symptoms that he believes he has, while in Münchhausen Syndrome, despite continuous complaints, the patient is fully aware that his symptoms are simulated. We must also distinguish it from the classic cases of hysteria, where both the production and the motivation of the symptoms are unconscious.

Diagnostic criteria

Normally, once other diseases have been ruled out, the diagnostic criteria are as follows:

1. Dramatic clinical picturethat describes spectacular illnesses.

2. Desire for tests, interventions, examinations... even if they are told that they are unnecessary.

3. History of many hospitalizations.

4. Evidence of self-medication or self-harm. such as: cuts, scars, bruises....

5. It is usually considered a bad patient as it does not collaborate in the treatments and puts in judgment the medical decisions.

Treatment of the syndrome

This phase is particularly difficult because the person with Münchhausen Syndrome, once he feels discovered, tends to become aggressive, once he feels he has been found out, tends to become aggressive.. After this, he disappears from the clinic and goes to another clinic where he explains his symptoms again.

In the treatment of patients with this syndrome there are two alternatives:

Direct confrontation.

An option in which the main problem is that the patient, as we have already said, leaves the hospital to go to another one, or accepts a psychiatric treatment that he will stop following and to which he will not return.

Indirect confrontation

In this strategy the patient is treated psychiatrically but without his knowledge. The aim is that, instead of simulating symptoms, patients learn to seek the attention of others in a different way. In addition, they should learn to cope better with stressful situations and ignore the thoughts that make them seek the sick role and hospitalization, all this with the help of psychologists and psychiatrists.

Finally, professionals should contribute to the improvement of the self-esteem of these people, and counteract the behaviors of the patients.and counteract phobic, insecure and dependent behaviors.