Lesson 1: Clinical Disorders – Part B

PART B

Munchausen Syndrome

Individuals with Munchausen syndrome pretend to have a physical illness and go from hospital to hospital seeking treatment. Often patients are very convincing with their portrayal of their chosen disorder. They may cut themselves, break bones, and induce fever from bacterial cultures to produce specific symptoms. Although individuals with Munchausen syndrome seek medical attention for physical injuries or illnesses, their true problem is a psychiatric one.

Individuals suffering from Munchausen syndrome generally have severe emotional difficulties, have histrionic personality features, and are intelligent. Patients know how to imitate the symptoms of their chosen disease and are quite knowledgeable of medical practices. Many individuals with Munchausen syndrome have had childhoods riddled with emotional and physical abuse. Patients have problems surrounding their self-concept and identity. They also have poor impulse control, a deficient sense of reality, short psychotic episodes, and unstable interpersonal relationships. They have an irresistible need to be taken care of, yet they do not trust authority figures and, instead, manipulate and provoke them. A unique variation of Munchausen syndrome is Munchausen syndrome by proxy. In these situations another person, usually a child, is used as a “substitute” patient by another individual, often a parent. The child may be purposefully injured (e.g., drugged), or their urine and stool samples contaminated to simulate disease.

Such parents seek medical care for their child, fabricate their child’s medical history, and appear deeply concerned and protective. The child is often gravely ill, requires frequent hospitalization, and may even die. A Hollywood example of Munchausen syndrome by proxy can be seen in the movie, The Sixth Sense.