Munchausen syndrome

Munchausen syndrome is a psychiatric disorder in which those affected feign disease, illness, or psychological trauma in order to draw attention or sympathy to themselves. It is in a class of disorders known as factitious disorders which involve "illnesses" whose symptoms are either self-induced or falsified by the patient. It is also sometimes known as hospital addiction syndrome.

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Syndrome

In Munchausen syndrome, the affected person exaggerates or creates symptoms of illnesses in themselves in order to gain investigation, treatment, attention, sympathy, and comfort from medical personnel. In some extremes, people suffering from Munchausen's Syndrome are highly knowledgeable about the practice of medicine, and are able to produce symptoms that result in multiple unnecessary operations. For example, they may inject a vein with infected material, causing widespread infection of unknown origin, and as a result cause lengthy and costly medical analyses and prolonged hospital stay. The role of "patient" is a familiar and comforting one, and it fills a psychological need in people with Munchausen's. It is distinct from hypochondria in that patients with Munchausen syndrome are aware that they are exaggerating, while sufferers of hypochondria actually believe they have a disease.

Origin of the name

The name derives from Baron Münchhausen (Karl Friedrich Hieronymus Freiherr von Münchhausen, 1720-1797), to whom were ascribed a series of fantastically impossible tales written by Rudolf Raspe.

In 1950, Sir Richard Asher (father of Jane Asher and Peter Asher) was the first to describe a pattern of self-harm, where individuals fabricated histories, signs, and symptoms of illness. Remembering Baron Munchausen, Asher named this condition Munchausen's Syndrome. Originally, this term was used for all factitious disorders. Now, however, there is considered to be a wide range of factitious disorders, and the diagnosis of "Munchausen syndrome" is reserved for the most severe form, where the simulation of disease is the central activity of the affected person's life.

Comparison to Fabricated or Induced Illness (FII)

Main article: Fabricated or Induced Illness

Fabricated or Induced Illness (FII) is the formal name of a type of abuse in which a caregiver feigns or induces an illness in a person under their care, in order to attract attention, sympathy, or to fill other emotional needs. It has been informally known as Munchausen Syndrome by Proxy (MSbP), due to its similarity to Munchausen syndrome, in which a person feigns or induces illness in themselves for similar emotional reasons. The syndrome was proposed in 1977 by the pediatrician Roy Meadow, and gained recognition from the Royal College Of Pediatrics and Child Health in 2002. Nevertheless, not all medical organizations agree on the nature and extent of the syndrome; whether it actually exists and the rate of prevalence if it does is a matter of dispute.

In popular culture

• On April 19 1983, the NBC television series St. Elsewhere aired the episode "Baron Von Munchausen" in which a patient is eventually diagnosed with Munchausen syndrome.^[1] This 1983 reference was probably the first time that Munchausen syndrome was referred to in an American network dramatic series. In the 1990s and later, almost every major medical drama on television has referred to either Munchausen syndrome or Munchausen syndrome by proxy.
• First airing October 11, 2005, an episode of FX's Nip/Tuck features a patient with Munchausen syndrome. She cuts herself to mimic the injuries left by the show's infamous face-slasher The Carver (and later actually becomes one of his victims).
• An episode of ABC-TV's Grey's Anatomy first airing October 16, 2005, features a patient diagnosed with Munchausen syndrome. She is portrayed taking Amitriptyline, an antidepressant that turned her urine blue.
• An episode (Deception, Season 2, Episode 9) of FOX's House, M.D. first aired on December 13, 2005, featured a patient played by Cynthia Nixon who admitted to Munchausen syndrome after being tricked into taking Rifampin, an antibiotic that turned her urine orange, but who was later additionally diagnosed with a real bacterial infection.
• An episode of NBC's Law & Order: Special Victims Unit (S07E15), first aired on Tuesday February 7, 2006, featured a woman, played by Rebecca De Mornay, who had Munchausen syndrome.
• In an episode of the British series Doctors, a woman is diagnosed with Munchausen syndrome after repeatedly faking illness in the form of stomach pain. She cuts herself to put blood in her urine, and has surgical scars on her stomach from previous medical investigations. She then pretends to attempt suicide.
• In the Seinfeld episode "The Scofflaw," a character played by Jon Lovitz fakes cancer for the attention (and subsequently receives gifts such as a toupee).
• In the book of Keeping Faith, written by Jodi Picoult, a woman thinks that Mariah White has this syndrome.
• Marshall Mathers, commonly known as Eminem, reports having been a "victim of Munchausen Syndrome" in his song, "Cleanin' Out My Closet."

See also

• Fabricated or Induced Illness, also known as Munchausen Syndrome by Proxy
• Psychosomatic illness
• Mythomania
• Histrionic personality disorder

References

• Feldman, Marc (2004). Playing sick?: untangling the web of Munchausen syndrome, Munchausen by proxy, malingering & factitious disorder. Philadelphia: Brunner-Routledge. ISBN 0-415-94934-3. 
• Fisher JA (2006). "Playing patient, playing doctor: Munchausen syndrome, clinical S/M, and ruptures of medical power". The Journal of medical humanities 27 (3): 135-49. doi:10.1007/s10912-006-9014-9. PMID 16817003.
• Fisher JA (2006). "Investigating the Barons: narrative and nomenclature in Munchausen syndrome". Perspect. Biol. Med. 49 (2): 250-62. doi:10.1353/pbm.2006.0024. PMID 16702708.
• Friedel,Robert O., MD Borderline Personality Disorder Demystified, Pg 9-10, Munchausen syndrome, Munchausen syndrome by Proxy. ISBN 1-56924-456-1