ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. F68
People with Munchausen syndrome represent a major challenge for doctors and nurses. In addition, a therapy is unfortunately difficult because sufferers usually reject it.Marian Grosser, Doctor ArticlesMünchhausen Syndrome
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
Munchausen syndrome: description
The Munchausen syndrome is a serious mental disorder. Those affected pretend physical or psychiatric symptoms as well as disabilities - or call them intentionally. Such behavior is also called an artificial disorder. They do not shy away from pain, permanent bodily harm or effort to credibly mediate being sick. Painful treatments or dangerous procedures such as surgery do not deter them. Her life is primarily about wandering from one doctor to another and from clinic to clinic.
Unlike other patients with an artificial disorder, they often invent spectacular medical histories and often think of experiences that affect other areas of life. The disorder is named after the famous "lying baron" Hieronymus Carl Friedrich von Münchhausen.
Distinction to simulants
The victims hurt themselves or pretend clever health problems. But they have no financial interests or other external incentives for their behavior, so they are not among the simulators. Her behavior is compulsive and aims to get attention and be treated medically. People with the Munchausen syndrome, however, are hard to distinguish from those who are psychologically sound and benefit from faking illnesses.
Who is affected by the Munchausen syndrome?
There are currently no studies that reliably assess the number of people affected. Experts believe that about two percent of all patients in the hospital suffer from artifactual disorders, part of which in turn is due to the Munchausen syndrome. The actual number could be much higher, however, as many cases are not recognized.
While artificial disorders mostly affect women, especially those with medical expertise, the Munchausen syndrome is more common in males. In addition to the symptoms of Munchausen syndrome they are often diagnosed with personality disorders such as borderline, narcissistic or dissocial personality disorder. People with Munchausen syndrome avoid staying in psychiatric or psychosomatic facilities. They usually have no insight or are afraid to give up their compulsive behavior.
Munchausen Syndrome Proxy
A special form is the Münchhausen Proxy syndrome also called Münchausen-by-proxy syndrome. The victims do not harm themselves, but others - most of them are mothers who hurt their children and get sick. Afterwards, they provide medical care and take care of them sacrificially. Even this shattering behavior does not happen out of malice or sadism, but out of an inner compulsion.To the table of contents
Munchausen syndrome: symptoms
The Munchausen syndrome belongs to the artificial disorders. It is characteristic that the patients pretend or artificially cause illnesses. However, unlike other people with artificial disorder, patients with the Munchausen syndrome do not have an intact social environment. The following are other symptoms that are typical of the Munchausen syndrome.
Patients with the Munchausen syndrome resort to sometimes drastic measures to receive medical treatment. They inflict wounds, infect or deplete their skin with fluids, get into the hypoglycaemia, or drain off blood to cause anemia.
They can also be so convincing organic problems such as gastrointestinal or heart problems, that they are operated by doctors. After surgery, they sabotage the healing process by, for example, infecting scars. The use of unnecessary drugs and drug abuse they use to harm the body.
Lack of suffering
The pain inflicted by the sufferers themselves or by unnecessary medical interventions, they seem to be indifferent. A healing is sabotaged. The goal is always to create or sustain a physical illness. Patients with the Munchausen syndrome are often noticed in clinics when they are not happy about a successful treatment.
Once they have been treated in a clinic, they stop their stay early against medical advice and can be admitted to another clinic. Even if the attending physician suspects, they are looking for a new one. Jumping from one doctor to the next is referred to as "doctor hopping" or "doctor shopping". As a result, they permanently change their whereabouts. Therefore, and also because they fear being confronted with the untruth of their stories, they have no social environment. The medical staff is often the only contact person.
Typical for the Munchausen syndrome is the so-called pathological lying or "Pseudologica phantastica". The patients invent uncontrolled and out of an inner compulsion constantly new stories of lies for their medical record. Her symptoms are very dramatic.
Behind the Munchausen syndrome is usually a personality disorder. The patients are in great conflict with their own identity and suffer from strong self-esteem problems. The invented stories help them to build up a new identity over and over again, of which they are sometimes self-confident. As physicians look behind the facade, they break off the relationship to protect their false identity.To the table of contents
Munchausen syndrome: causes and risk factors
The exact causes of the Munchausen syndrome are still unknown. However, many patients report traumatic childhood experiences. These can be, for example, frequent loss experiences, mistreatment or neglect in childhood. In some cases, one parent has already suffered from the Munchausen syndrome.
Some experts suspect life tiredness behind the Munchausen syndrome. The constant self-harming behavior is an indication of the attempt to take your own life. At the same time it reveals the disturbed self-image. The often underlying personality disorders also play a central role.To the table of contents
Munchausen syndrome: examinations and diagnosis
For doctors, the Münchhausensyndrom is difficult to see, because patients rarely stay longer time with a doctor. The Munchausen patients play the diseases very credible, so that the doctor will first perform detailed investigations and treat self-generated injuries. Only after some time or through discussions with a previous doctor, the Münchhausen syndrome falls on.
An indication of a Munchausen syndrome is the indifference of patients to painful or dangerous medical procedures. It is also striking that, according to the patient, the symptoms worsen again and again after they have been treated. If it turns out in the course of treatment that the symptoms are brought about for no apparent reason, the doctor will recommend a psychiatrist or psychotherapist.
According to the international classification of mental disorders (ICD-10) the following criteria for the Munchausen syndrome must apply:
- Persistent behaviors that cause or simulate symptoms and / or self-injury to cause symptoms.
- There is no external motivation, such as financial compensation, for this behavior.
- Exclusionary provision is the absence of a confirmed physical or mental disorder that could explain the symptoms.