Munchausen Syndrome

Munchausen Syndrome Overview

Munchausen syndrome is a condition in which a person intentionally fakes, simulates, worsens, or self-induces an injury or illness for the main purpose of being treated like a medical patient. Munchausen syndrome is named after a German military man, Baron von Munchausen, who traveled around telling fantastic tales about his imaginary exploits. In 1951, Richard Asher applied the term to people traveling from hospital to hospital, fabricating various illnesses.

The term Munchausen syndrome is often used interchangeably with factitious disorder. Factitious disorder refers to any illness that is intentionally produced for the main purpose of assuming the sick role, although that purpose is unknown to the "sick" person. Munchausen syndrome most appropriately describes persons who have a chronic variant of a factitious disorder with mostly physical signs and symptoms, although there are reports in literature regarding psychological Munchausen syndrome, meaning that the simulated symptoms are psychiatric in nature.

Persons with Munchausen syndrome intentionally cause signs and symptoms of an illness or injury by inflicting medical harm to their body, often to the point of having to be hospitalized. These persons are sometimes eager to undergo invasive medical interventions. They are also known to move from doctor to doctor, hospital to hospital, or town to town to find a new audience once they have exhausted the workup and treatment options available in a given medical setting. Persons with Munchausen syndrome may also make false claims about their accomplishments, credentials, relations to famous persons, etc.

A related condition, called Munchausen by proxy syndrome, refers to a caregiver who fakes symptoms by causing injury to someone else, often a child, and then wants to be with that person in a hospital or similar medical setting.

Munchausen Syndrome Causes

The causes of Munchausen syndrome are unknown. Some experts suggest that it is a defense mechanism against sexual and aggressive impulses. Others believe it may be a form of self-punishment. Determining an exact cause is difficult because persons with Munchausen syndrome are not open and honest about their condition, making research on them nearly impossible.

Munchausen Syndrome Symptoms

Individuals with Munchausen syndrome intentionally produce or exaggerate symptoms. They may lie about or fake symptoms, self-induce injury to cause symptoms, or alter the results of tests by contaminating samples such as a urine sample. Signs and symptoms of Munchausen syndrome may include the following:

• Dramatic medical history of serious illness, often with inconsistent details of the problem
  
• Symptoms that fit a diagnosis too perfectly or lack of signs that go with symptoms (for example, no sign of dehydration yet the person complains of diarrhea and vomiting)
  
• Symptoms that change or worsen once a treatment is begun
  
• History of seeking care at numerous other doctors, offices, or hospitals
  
• Eagerness to undergo exams, tests, and procedures
  
• Reluctance to let health care providers contact previous health care providers or family and friends
  
• Evidence of multiple surgical scars