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Munchausen Syndrome

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Munchausen syndrome is a factitious disorder, a mental disorder in which a person repeatedly and deliberately acts as if he or she has a physical or mental illness when he or she is not really sick. Munchausen syndrome is considered a mental illness because it is associated with severe emotional difficulties.

Munchausen syndrome, named for Baron von Munchausen, an 18th century German officer who was known for embellishing the stories of his life and experiences, is the most severe type of factitious disorder. Most of the symptoms in people with Munchausen syndrome are related to physical illness -- symptoms such as chest pain, stomach problems, or fever -- rather than those of a mental disorder.

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NOTE: Although Munchausen syndrome usually refers to a factitious disorder with mostly physical symptoms, the term is sometimes used to refer to factitious disorders in general. In this article, Munchausen syndrome refers to the type of factitious disorder with mostly physical symptoms.

What Are the Symptoms of Munchausen Syndrome?

People with Munchausen syndrome deliberately produce or exaggerate symptoms in several ways. They may lie about or fake symptoms, hurt themselves to bring on symptoms, or alter tests (such as contaminating a urine sample). Possible warning signs of Munchausen syndrome include:

  • Dramatic but inconsistent medical history
  • Unclear symptoms that are not controllable and that become more severe or change once treatment has begun
  • Predictable relapses following improvement in the condition
  • Extensive knowledge of hospitals and/or medical terminology, as well as the textbook descriptions of illnesses
  • Presence of multiple surgical scars
  • Appearance of new or additional symptoms following negative test results
  • Presence of symptoms only when the patient is with others or being observed
  • Willingness or eagerness to have medical tests, operations, or other procedures
  • History of seeking treatment at numerous hospitals, clinics, and doctors offices, possibly even in different cities
  • Reluctance by the patient to allow doctors to meet with or talk to family, friends, or prior doctors
  • Problems with identity and self-esteem

What Causes Munchausen Syndrome?

The exact cause of Munchausen syndrome is not known, but researchers are looking at the role of biological and psychological factors in its development. Some theories suggest that a history of abuse or neglect as a child, or a history of frequent illnesses that required hospitalization might be factors in the development of the syndrome. Researchers are also studying a possible link to personality disorders, which are common in people with Munchausen syndrome.

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