BY DR SAMUEL OLUWATOSIN (MBChB, Ife)
What is this condition?
It’s a severe form of ‘factitious disorder,’ which simply means feigned or fake illness.
It refers to a condition in which an individual fabricates symptoms to gain hospital admission.
It was named after a man called Karl Friedrich Von Munchausen who was notorious for entertaining people with unreal stories as he travelled round the world like saying he rode on cannon balls.
The major gain is becoming a “patient” which is different from malingering where the individual hopes to gain some other things like avoiding going to work, or being paid some money for it.
They engage in lying about their health that is so fascinating to the listeners and they usually have extensive knowledge of medical terminologies and how the hospital runs.
Another form of it is called Munchausen by proxy when a false illness is imposed on another person, e.g. a mother complaining and insisting a healthy child has an illness he or she doesn’t have.
What are the symptoms of this condition?
- Lying or faking a complaint including harming themselves to achieve it
- Complaints are unclear and worsens or change during treatment
- Have new complaints after initial laboratory findings are normal
- Symptoms are present only when the individual is with other people
- Several treatments in the past from different places
- Reluctance to allow the doctors speak with family members about the complaints
How common is this condition?
- Quite rare
- Commoner in men especially those young usually between 20 to 40 years of age with a history of employment or education in health care.
- Low socioeconomic status
- Associated with other mental conditions like mood problems.
What causes it?
Exact cause is not known but the following situations are commoner in them;
- Being abused as a child
- Having serious illness during childhood that allowed being over cared for
- Having a relative with a serious illness
- Having a poor sense of identity or self-esteem
- Losing a loved one through death, illness or abandonment early in life
- Unfulfilled desire to be a doctor or other health professional
- Working in the health care field
- Personality problems
- Poor coping skills
How is it diagnosed?
Can be difficult to diagnose.
Usually, referring the individuals with suspected condition to a mental health specialist is required.
An individual’s readiness to submit to procedures/surgeries that would normally provoke anxiety in others should raise an index of suspicion.
Can it be treated?
Yes using psychotherapy, which is a form of treatment that entails talking about the problem rather than using drugs.
It is quite challenging to individuals with such problem to accept this treatment as they will rather be treated for the invented complaints rather than the actual problem.
Drugs may however be added if there are associated mood problems ascertained by the mental health specialist.
What are the problems that may result from this condition if untreated?
Risk of harming themselves from trying to invent the complaints, or from unnecessary investigations by medical personnels and treatment of the ‘fake’ complaints.
It some cases, it can result to death.
On a final note;
Munchausen syndrome is usually a long term problem that can be difficult to treat because of the general unwillingness by the patient to undergo appropriate treatment.
However, if addressed early with standard treatment, better outcome is feasible.