Münchhausen syndrome: causes, symptoms and treatment
The baron of Münchhausen, a German baron who served Antonio Ulrico II and later enlisted in the Russian army, lends the name to this syndrome so disturbing because the baron, on returning to his birthplace, narrated unlikely and invented stories about his adventures away from home, among which stand out riding on the bullet of a cannon and go to the moon.
He had been born one of the first cases of Münchhausen syndrome , which has gained some popularity for its appearance in the House series but which is, after all, a totally real phenomenon.
What is Münchhausen syndrome?
This factitious disorder consists in a constant and intentional simulation of diseases, normally very convincing and spectacular. To this end, the patient can become self-injurious, ingest toxic substances and even self-inject bacteria such as Escherichia coli. The affected person has the motivation to assume the role of the sick person and to feel cared for and cared for .
This mental disorder usually begins in the early stages of adulthood, is more common among men and especially among people who work in a medical services environment, many of whom have knowledge and a capacity to access materials that facilitate the reproduction of the syndrome.
Symptoms of Münchhausen syndrome
Symptoms are limited by the patient's knowledge or fantasy . Although these are very varied, the most common are allergic reactions, respiratory problems, seizures, diarrhea, fever, fainting, vomiting, and even hydroelectric disorders. In addition, people who have this syndrome also usually require large doses of painkillers and narcotics.
Patients who have Münchhausen syndrome often visit different hospitals complaining of the same ailments that they have described in the previous hospital they went to; In addition, their medical knowledge and the precision in the representation of their symptoms mean that doctors have to repeatedly perform different tests and diagnostic methods. They never oppose any test however painful it is going to be and they have special submission at the time of hospitalization in a health center .
This disorder can be of different intensity depending on the affected person. For example, in Cuba, serious cases have been described in which the patient has arrived to inoculate the HIV virus.
Characteristics and basic signs
The patient of Münchhausen can be described in the following points:
- Constant search for the role of the sick.
- Self-injury and self-administration of drugs to cause symptoms that may have an appearance of credibility.
- Very repeated assistance to hospitals.
- Aggressive behavior when being blamed for simulating the symptoms or when a doctor refuses to do any test (even if it is unnecessary).
- High knowledge of medical concepts.
Diagnosis of Münchhausen syndrome
Diagnosis of the patient from Münchhausen it is based on the elimination of other psychiatric syndromes once it has been detected that the patient has a disorder of this nature .
On the one hand, medical specialists must rule out other pathologies with very similar characteristics, such as somatization disorder, where there are physical symptoms without a medical illness explaining them. The main difference between somatization disorder and Münchhausen syndrome is that in the first there is a real physical symptomatology, although of unknown origin.
On the other hand, the hypochondriac patient exaggerates symptoms that he thinks he has, whereas in Münchhausen syndrome, despite the continuous complaints, the patient is fully aware that his symptoms are simulated. We must also distinguish it from the classic cases of hysteria, where both the production and the motivation of the symptoms are unconscious.
The diagnostic criteria
Normally, once other diseases are ruled out, the diagnostic criteria are these:
1. Dramatic clinical picture , which describes spectacular diseases.
2. Desire to have tests, interventions, exams ... even if they are told they are unnecessary.
3. Background of many hospitalizations.
4. Evidence of self-medication or self-injury as: cuts, scars, bruises ...
5. It is usually considered a bad patient since it does not collaborate in the treatments and puts in judgment the medical decisions.
Treatment of the syndrome
This phase has special difficulty, since the person who presents Münchhausen Syndrome, Once you feel naked, you tend to get aggressive . After this, he disappears from the clinic and goes to another one where he explains his symptoms again.
In the treatment for patients with this syndrome there are two alternatives:
Direct confrontation
An option in which the main problem is that the patient, as we have said, leaves the hospital to go to another, or accepts a psychiatric treatment that will stop following and to which he will not return.
Indirect confrontation
In this strategy the patient is treated psychiatrically but without this being known. The goal is that, instead of simulating symptoms, patients learn to seek the attention of others in a different way. In addition, they must learn to fight in a better way with stressful situations and ignore the thoughts that make them look for the role of sick and hospitalization, all this with the help of psychologists and psychiatrists.
By last, professionals should contribute to the self-esteem of these people improve , and counteract phobic behavior, insecurity and dependence.
