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Munchausen Syndrome

How Is Munchausen Syndrome Diagnosed?

Diagnosing Munchausen syndrome is very difficult because of, again, the dishonesty that is involved. Doctors must rule out any possible physical and mental illnesses before a diagnosis of Munchausen syndrome can be considered.

If the doctor finds no physical reason for the symptoms, or if the pattern of physical symptoms that someone describes suggests that they may be self-inflicted, then he or she will likely refer the person to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for Munchausen syndrome. The doctor bases his or her diagnosis on the exclusion of actual physical or mental illness and his or her observation of the patient's attitude and behavior.

How Is Munchausen Syndrome Treated?

Although a person with Munchausen syndrome actively seeks treatment for the various disorders he or she invents, the person often is unwilling to admit to and seek treatment for the syndrome itself. This makes treating people with Munchausen syndrome very challenging, and the outlook for recovery poor.

When treatment is sought, the first goal is to modify the person's behavior and reduce his or her misuse or overuse of medical resources. Once this goal is met, treatment aims to work out any underlying psychological issues that may be causing the person's behavior.  Another key goal is to help patients avoid dangerous and unnecessary medical diagnostic or treatment procedures (such as surgeries), often sought from different doctors who may be unaware that physical symptoms are either being faked or self-inflicted.

As with other factitious disorders, the primary treatment for Munchausen syndrome is psychotherapy or talk therapy (a type of counseling). Treatment usually focuses on changing the thinking and behavior of the individual (cognitive-behavioral therapy). Family therapy may also be helpful in teaching family members not to reward or reinforce the behavior of the person with the disorder.

There are no medications to treat factitious disorders themselves. Medication may be used, however, to treat any related illness, such as depression or anxiety. The use of medications must be carefully monitored in people with factitious disorders due to the risk that the drugs may be used in a harmful way.

What Is the Outlook for People With Munchausen Syndrome?

People with Munchausen syndrome are at risk for health problems (or even death) associated with hurting themselves or otherwise causing symptoms. In addition, they may suffer from reactions or health problems associated with multiple tests, procedures, and treatments; and are at high risk for substance abuse and attempts at suicide

Because many people with factitious disorders deny they are faking or causing their own symptoms and will not seek or follow treatment, recovery is dependent on a doctor or loved one identifying or suspecting the condition in the person and encouraging them to receive proper medical care for their disorder and sticking with it.

Some people with Munchausen syndrome suffer one or two brief episodes of symptoms. In most cases, however, the disorder is a chronic, or long-term, condition that can be very difficult to treat.

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