Generality
Münchausen syndrome is a mental and behavioral disease, which causes people to complain of problems and symptoms invented; all with the sole intention of putting themselves at the center of the scene and looking like seriously ill.
The symptoms of Münchausen syndrome consist in very particular behaviors, such as for example self-production of physical damages, altering diagnostic tests, undergoing invasive and dangerous treatments, etc. without reason.
Diagnosis is not easy at all, because patients can pretend very well.
To heal, you need a remarkable collaboration on the part of the patient, who must realize that he is suffering from Münchausen's syndrome and needs help.
What is Münchausen syndrome?
Münchausen syndrome is a psychiatric and behavioral disorder, which causes those affected to complain of diseases and symptoms that do not exist for the sole purpose of focusing on the attention of a patient.
In other words, people with Münchausen syndrome try in every way to take center stage, inventing physical or psychological problems or deliberately hurting themselves.
PLEASE NOTE: Münchausen syndrome is also known as a dummy disorder or hospital addiction .
Epidemiology
Some Anglo-Saxon research reports that the main illnesses of Münchausen are:
- Women between 20 and 40, who very often work in some hospital as a nurse or laboratory technician.
- Unmarried white men between 30 and 50 years old.
It is difficult to establish how widespread Münchausen syndrome is, as the people who are affected are very good at deceiving doctors. Suffice it to say that some particularly serious patients, if discovered, turn to other doctors by changing their identity.
VARIANT OF THE MÜœNCHAUSEN SYNDROME
Figure: A classic example of Münchausen syndrome by proxy is represented by mothers who voluntarily make a child ill, to attract attention.
Some people voluntarily cause damage to those who depend on them in order to attract attention. This particular behavior is related to the Münchausen syndrome and is in fact also called Münchausen syndrome by proxy .
A classic example of Münchausen syndrome by proxy is represented by certain mothers who, to put themselves at the center of the scene, do everything to make their children ill.
IS HYPOCHONDRY? OR IS THE THING "THINK YOU I LOVE"?
Münchausen's syndrome is neither hypochondria nor the so-called " pretending to be sick " to avoid some annoying tasks.
Hypochondriacs are people obsessed with having some disease and who "see", in every little malaise, a serious pathology. It is not, however, in their intentions to put themselves morbidly in the spotlight.
The people who have the habit of pretending to be sick, on the other hand, are subjects that have a much more concrete personal purpose than the Münchausen syndrome patients: they try, with their "inventions", to free themselves from burdensome and unwelcome commitments (for example, in the workplace or at school).
WHERE DOES THE NAME COME FROM?
Figure: the baron of Münchausen and his adventures were also the subject of a film.
The name Münchausen syndrome derives from a German aristocrat, Baron Karl Friedrich Hieronymus Freiherr von Münchhausen, who was famous for telling fantastic stories and adventures to which he had participated as a protagonist.
Causes
The causes of the onset of Münchausen's syndrome are unclear and still have outstanding points. According to the experts, who are keen to point out that every theory has yet to be proven, hospital dependency could be due to:
- A particular childhood, characterized by an affective trauma, an emotional disorder or a disease for which long medical treatment has been practiced.
- A personality disorder, or a mental health problem in which the affected patient has abnormal thoughts and behavior.
TRAUMATIC CHILDHOOD
The thesis that a traumatic and difficult childhood can give rise to the Munchausen syndrome derives from the observation that:
- Some patients have been abandoned or over-neglected by their parents during their childhood. According to the experts, this neglect has given rise to these people with the desire to place themselves at the center of attention, sometimes even with dangerous methods (such as purposely obtaining wounds).
- Other patients were affected, at a young age, by a disease that required special attention and prolonged medical treatment. According to the supporters of the aforementioned thesis, an event of this kind can lead an individual to desire, even in adulthood, the same concerns and the same concerns from the world around him.
PERSONALITY DISORDER?
According to some scholars of mental illness, there are personality disorders strongly related to Münchausen syndrome (NB: this belief derives from the fact that patients show the symptoms). The three main ones are:
- The antisocial personality disorder . Individuals who are affected despise any law or rule of society, are aggressive, irresponsible, indifferent to the feelings of others and disregarding their own or others' security.
- Borderline personality disorder . People who are affected have an unstable mood, are extremely impulsive, have turbulent relationships with others and struggle to organize their thoughts.
- The narcissistic personality disorder . The subjects who are affected believe they are special or unique, are only concerned about their own personal success, do not give any importance to the feelings of others and are convinced that others feel envy for them.
As you can guess, the three conditions described above lead the patient to isolate himself from the social context and not to have affections or stable relationships with relatives and friends.
Symptoms and Complications
People with Münchausen syndrome complain of illnesses they do not have or self-procure physical damage to be sick with something, and put themselves at the center of attention.
They have various habits:
- "They choose" symptoms or physical problems that are difficult to prove or document, such as severe headaches, intense belly pains, fainting, epilepsy attacks, etc.
- Alter the result of diagnostic tests that are easy to tamper with. For example, they heat the thermometer they used to measure body temperature or add blood to the urine collected for analysis.
- Self-inflicted cuts and burns, deliberately taking large doses of drugs and / or voluntarily eating expired or poorly preserved foods.
- They do everything to worsen their non-optimal health condition. For example, if they got a wound (deliberately or not, it's not important), they try to infect it anyway, by touching feces and any object that can be a source of bacteria.
OTHER SYMPTOMATIC BEHAVIORS OF THE MUNCHAUSEN SYNDROME
Patients with Münchausen syndrome are also characterized by other particular behaviors (such as, for example, telling incredible stories about their past, constantly going to all the hospitals in the area where they live, etc.), which are considered extremely indicative of the disease.
The complete list of these behaviors, which could be defined as symptomatic, is shown in the table below.
Table. Complete overview of the symptomatic behaviors of a Münchausen syndrome patient. |
| All the hospitals in the area often frequent. |
They claim to have had a serious illness in the past, but could not document it with anything, because, at the time of this, they lived abroad. |
They report symptoms that are not confirmed by any diagnostic tests performed. |
They have excellent medical knowledge. |
While they are hospitalized, they do not receive any visits from relatives and friends (NB: because they are people who tend to isolate themselves). |
Unlike normal people, who fear surgical interventions and invasive diagnostic procedures, they are very available for any kind of treatment, even if extremely dangerous. |
They are very vague in reporting the symptoms of a disease they claim to have or describe them as having consulted a medical text a few moments before. |
They tell fantastic stories about their past (for example, they say they were former sports champions) or about the past of closest relatives. |
They enroll in online support groups reserved for people with serious illnesses and participate as if they were real patients ("Münchausen on the internet") |
MÜœNCHAUSEN SYNDROME DISEASES AND INTERNET
It has recently been discovered that people with Münchausen syndrome enroll in online support groups for people with serious illnesses (such as solid tumors, leukemia, cystic fibrosis, etc.) and deceive all participants by telling completely invented stories.
This very unpleasant situation is now considered a symptom of the disease and was defined by the experts as " Münchausen on the internet " (in English it is: Münchausen by internet ).
How to recognize a Münchausen syndrome patient on the web?
An expert of the so-called "Münchausen on the internet" has compiled a list of the typical symptomatic behaviors of those who are affected by this condition. Here are the key points:
- They generally write very long messages, rich in information and similar in style to a medical website.
- They report that they were the protagonists of very serious situations, which, however, were resolved with a miraculous cure.
- They often contradict each other, because they forget what they say in the first place.
- They report that they are continually at the center of dramatic life experiences, concerning them or their close relatives.
Diagnosis
Diagnosing Münchausen syndrome is not easy at all, even for an experienced doctor. This is due to the fact that people with this disease know how to pretend very well and know different ways, all very effective, to obtain damages without arousing the slightest suspicion.
How is it then possible to notice it?
To diagnose hospital addiction it is necessary to pay attention to the details and, above all, to the behaviors that have been defined as symptomatic in the previous chapter.
WHAT DO THE DOCTORS DO IF THEY HAVE SUSPECTED?
If a doctor suspects a patient, he generally proceeds as follows. First, it assesses whether or not there is consistency between what is claimed by the potential Münchausen syndrome patient and what emerges from the preliminary clinical investigations concerning the latter.
Secondly, try to get in touch with family members or close friends of the patient, to find out if their loved one is a sincere person or if he has some mental disorder.
Finally, he prescribes in-depth tests and chuck-ups, in order to clarify whether physical disturbances are self-procured or not (for example, through a blood test, he understands whether the patient has taken drugs that could give one of the symptoms shown by the patient).
DIFFERENTIAL DIAGNOSIS
Once it is established that the patient lies about his or her state of health, the doctor is called to discover the reason for this behavior. To clarify this, proceed by exclusion, focusing on three issues:
- Is the subject for an economic purpose, such as obtaining a disability or compensation?
- Does the subject hope to receive opioid-based pain medications (which can be addicted)?
- Does the subject lie in order to be absent from work or to escape from some burdensome task?
If the answer to the three aforementioned questions is no, and if the only real motivation is to place yourself at the center of attention, then it is possible that the patient suffers from Münchausen syndrome.
The three fundamental points on which the diagnosis of Münchausen syndrome is based:
- The clinical data confirm that the patient procures the damage he complains to the doctor.
- The motivation for inventing, or for self-procuring, disorders is due to the desire to pass for a patient.
- There are no other reasons, other than the previous ones, which push us to act against ourselves and hurt ourselves.
Treatment
It is very difficult to treat people with Münchausen syndrome because, very often, they do not admit or realize that they are sick and need help. This leads to the rejection of any form of psychotherapy and the support of experts in the field. However, when the patient is able to understand his condition and agrees to collaborate with his psychotherapist, he has a good chance of healing.
During the therapeutic course, the support of family members and close friends is also essential, who must not isolate the sick relative but be close to him, especially in the worst moments.
PSYCHOTHERAPY
A collaborative patient, in the hands of an experienced psychotherapist, is generally subjected to psychoanalysis and cognitive-behavioral psychotherapy.
Psychoanalysis is based on research and the resolution of wrong unconscious beliefs (which, according to Sigmund Freud who was the founder of psychoanalysis, are the reason for many mental illnesses).
Cognitive-behavioral psychotherapy, on the other hand, consists in preparing the patient to recognize and dominate the so-called "distorted thoughts" (ie the symptoms of Münchausen syndrome). It includes a part "in the studio", with the psychotherapist, and a part "at home", reserved for the exercise and improvement of the domain techniques.
SUPPORT FOR FAMILIES
As anticipated, close family members and friends must help the patient, even if it can sometimes be difficult to stay with him. To succeed in this, it is essential that these people understand the main features of Münchausen syndrome and know how to behave in times of need.
DRUGS
During psychotherapy, it is possible that antidepressant drugs, such as selective serotonin reuptake inhibitors ( SSRIs ), may also be prescribed to cope with possible forms of depression due to social isolation.
However, it is good to remember that, with antidepressants alone, you cannot recover from Münchausen's syndrome.
