Munchausen syndrome

Infobox_Disease
Name = Munchausen syndrome


Caption =
DiseasesDB = 8459
DiseasesDB_mult = DiseasesDB2|33167
ICD10 = ICD10|F|68|1|f|60
ICD9 = ICD9|301.51
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj = med
eMedicineTopic = 3543
eMedicine_mult = eMedicine2|emerg|322 eMedicine2|emerg|830
MeshID = D009110

Munchausen syndrome is a psychiatric disorder in which those affected fake disease, illness, or psychological trauma in order to draw attention or sympathy to themselves. It is in a class of disorders known as factitious disorders which involve "illnesses" whose symptoms are either self-induced or falsified by the patient. It is also sometimes known as hospital addiction syndrome.

Description

In Munchausen syndrome, the affected person exaggerates or creates symptoms of illnesses in themselves in order to gain investigation, treatment, attention, sympathy, and comfort from medical personnel. In some extremes, people suffering from Munchausen's Syndrome are highly knowledgeable about the practice of medicine, and are able to produce symptoms that result in multiple unnecessary operations. For example, they may inject a vein with infected material, causing widespread infection of unknown origin, and as a result cause lengthy and costly medical analyses and prolonged hospital stay. The role of "patient" is a familiar and comforting one, and it fills a psychological need in people with Munchausen's. It is distinct from hypochondria in that patients with Munchausen syndrome are aware that they are exaggerating, while sufferers of hypochondria actually believe they have a disease.

In many cases, a similar behavior called "Munchausen 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. Regardless of the mental health of the adult, this is a serious form of child abuse. Munchausen syndrome by proxy is considered distinct from "Munchausen syndrome".

Origin of the name

The syndrome name derives from Baron Münchhausen (Karl Friedrich Hieronymus Freiherr von Münchhausen, 1720-1797) who purportedly told many fantastical and impossible adventures about himself, which Rudolf Raspe later published as "The Surprising Adventures of Baron Munchausen".

In 1951, Richard Asher was the first to describe a pattern of self-harm, where individuals fabricated histories, signs, and symptoms of illness. Remembering Baron Munchausen, Asher named this condition Munchausen's Syndrome and wrote in the British medical journal the Lancet:

"Here is described a common syndrome which most doctors have seen, but about which little has been written. Like the famous Baron von Munchausen, the persons affected have always travelled widely; and their stories, like those attributed to him, are both dramatic and untruthful. Accordingly the syndrome is respectfully dedicated to the Baron, and named after him."Citation
title = R. A. J. Asher (Obituary notice)
journal = British Medical Journal
volume = 2(5653)
pages = 388
date = 1969-05-10
year = 1969
url = http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1983233&pageindex=2#page
accessdate = 2008-03-20] [Lancet 1951 Feb 10;1(6650):339-41]

Originally, this term was used for all disorders. Now, however, there is considered to be a wide range of factitious disorders, and the diagnosis of "Munchausen syndrome" is reserved for the most severe form, where the simulation of disease is the central activity of the affected person's life.

Comparison to fabricated or induced illness (FII)

Fabricated or induced illness (FII) is the formal name of a type of abuse in which a caregiver feigns or induces an illness in a person under their care, in order to attract attention, sympathy, or to fill other emotional needs. It is also known as "Munchausen Syndrome by Proxy" (MSbP), due to its similarity to Munchausen syndrome, in which a person feigns or induces illness in "themselves" for similar emotional reasons. The syndrome was proposed in 1977 by the pediatrician Roy Meadow, and gained recognition from the Royal College of Pediatrics and Child Health in 2002. Nevertheless, not all medical organizations agree on the nature and extent of the syndrome; whether it actually exists and, if it does, the prevalence is a matter of dispute.

Illnesses and conditions that are feigned by Munchausen sufferers

*Allergies
*Anxiety disorder
*Arthritis
*Asperger syndrome
*Attention deficit disorder (ADD)
*Back pain
*Bipolar disorder (manic depression)
*Cancer
*Clinical depression
*Dissociative identity disorder (multiple personalities)
*Domestic abuse
*Electrolyte disturbance
*Fibromyalgia
*Acid reflux
*Heart disease
*Immune deficiency disorder
*Joint pain
*Learning disability
*lupus
*Muscle pain
*Migraines
*kidney disease
*Obsessive-compulsive disorder
*Post-traumatic stress disorder
*Sexual abuse
*Spousal abuse
*Suicidal ideation
*May have multiple scars on abdomen due to repeated "emergency" operationsNote that many of these conditions do not have clearly observable or diagnostic symptoms.

ee also

*Fabricated or induced illness, also known as "Munchausen Syndrome by Proxy"
*Histrionic personality disorder
*Munchausen by Internet
*Mythomania
*Psychosomatic illness

References

*
*
*
* Friedel,Robert O., MD Borderline Personality Disorder Demystified, Pg 9-10, Munchausen syndrome, Munchausen syndrome by Proxy. ISBN 1-56924-456-1

External links

* [http://www.munchausen.com/ Dr. Marc Feldman's Munchausen Syndrome, Malingering, Factitious Disorder, & Munchausen by Proxy Page] - Page offering information on Munchausen and its many other names. Offers information on Dr. Feldman's books and his email address for interested parties.
* [http://discovermagazine.com/1993/jul/thebaronstrikesa243 Article in Discover magazine, July 1993, by Abigail Zuger]
* [http://www.giorgioclementi.it/medea.htm The Medea of the modern times]