Münchausen syndrome/By Proxy

Münchausen syndrome is a psychiatric factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention or sympathy to themselves or their children. It is also sometimes known as hospital addiction syndrome or hospital hopper syndrome.

Nurses and doctors sometimes refer to them as frequent flyers, because they return to the hospital just as frequent flyers return to the airport. However, there is discussion to reclassify them as somatoform disorder in the DSM-5 as it is unclear whether or not people are conscious of drawing attention to themselves. People with Munchausen’s syndrome create the symptoms of illness, either in themselves or in another person.

They may create their illness by pretending to have symptoms that don’t really exist, or by deliberately harming themselves. They may inflict cuts and bruises, for example, or even ingest toxic substances.

Münchausen syndrome is related to Münchausen syndrome by proxy (MSbP/MSP), which refers to the abuse of another being, typically a child, in order to seek attention or sympathy for the abuser.

Some Cases of Münchausen syndrome

Mum tried 13 times to choke tot - Andrea Kirkham

Hospital admits errors as salt death mother jailed - Petrina Stocker

Child killer nurse Beverly Allitt sentenced to a minimum of 30 years - Beverly Allitt

Faked baby illness woman jailed - Suzanne McDaid

Devon woman jailed for ‘sick son’ con - Lisa Hayden-Johnson

Man tricked doctors into giving hospital treatment

Which symptoms are reported?

The most common symptoms that patients with Munchausen’s complain of include breathlessness, allergic reactions, diarrhoea and vomiting, seizures, abdominal pain and blackouts.

Those with Munchausen’s will often attend many different hospitals and clinics. Each time, they’ll tell the same or a similar story and report the same symptoms, so they undergo the same investigations time and again.

Even if someone attends the same hospital on a regular basis, the accuracy of the portrayal of symptoms leaves staff no choice but to run tests again.

Who’s affected?

It usually begins in early adulthood. Those who work in a healthcare environment are at greater risk of developing it. Some people believe that experiencing abuse or neglect in childhood increases the risk.

Description

In Münchausen syndrome, the affected person exaggerates or creates symptoms of illnesses in themselves to gain investigation, treatment, attention, sympathy, and comfort from medical personnel. In some extreme cases, people suffering from Münchausen’s syndrome are highly knowledgeable about the practice of medicine and are able to produce symptoms that result in lengthy and costly medical analysis, prolonged hospital stay and unnecessary operations. The role of “patient” is a familiar and comforting one, and it fills a psychological need in people with Münchausen’s. It is distinct from hypochondriasis in that patients with Münchausen syndrome are aware that they are exaggerating, whereas sufferers of hypochondriasis believe they actually have a disease. Risk factors for developing Münchausen syndrome include childhood traumas and growing up with parents/caretakers who were emotionally unavailable due to illness or emotional problems. Arrhythmogenic Münchausen syndrome describes individuals who simulate or stimulate cardiac arrhythmias to gain medical attention.

A similar behavior called Münchausen syndrome by proxy has been documented in the parent or guardian of a child. The adult ensures that his or her child will experience some medical affliction, therefore compelling the child to suffer treatment for a significant portion of their youth in hospitals. Furthermore, a disease may actually be initiated in the child by the parent or guardian. This condition is considered distinct from Münchausen syndrome. In fact, there is growing consensus in the pediatric community that this disorder should be renamed “medical abuse” to highlight the real harm caused by the deception and to make it less likely that a perpetrator can use a psychiatric defense when real harm is done. Parents who perpetrate this abuse are often affected by concomitant psychiatric problems like depressionspouse abusepsychopathy, or psychosis. In rare cases, multiple children in one family may be affected either directly as victims or as witnesses who are threatened to keep them silent.

Treatment and prognosis

Medical professionals or doctors suspecting Münchausen’s in a patient should first rule out the possibility that the patient does indeed have a disease state but in an early stage and not yet clinically detectable. Providers need to acknowledge that there is uncertainty in treating suspected Münchausen patients so that real diseases are not under-treated. Then they should take a careful patient history and seek medical records, to look for early deprivation,childhood abuse, or mental illness. If a patient is at risk to himself or herself, inpatient psychiatric hospitalization should be initiated.

Medical providers or doctors should consider working with mental health specialists to help treat the underlying mood or disorder as well as to avoid counter transference. Therapeutic and medical treatment should center on the underlying psychiatric disorder: a mood disorder, an anxiety disorder, or borderline personality disorder. The patient’s prognosis depends upon the category under which the underlying disorder falls; depression and anxiety, for example, generally respond well to medication and/or cognitive behavioral therapy, whereas borderline personality disorder, like all personality disorders, is presumed to be pervasive and more stable over time,thus offers the worst or best prognosis.