Münchausen Syndrome

by Dr. Lorin Bradbury

Question: What is Münchausen Syndrome?

Münchausen Syndrome is a serious psychiatric disorder wherein an individual has a need to assume a “sick role.” This is accomplished by feigning a disease, illness, or psychological trauma in order to draw attention or sympathy to self. It is in a class of disorders known as factitious disorders which involve so-called illnesses in which symptoms are either self-induced or falsely reported by the patient.

In Münchausen Syndrome, the affected person exaggerates or creates symptoms of illnesses in order to gain treatment, attention, sympathy, and comfort from medical personnel.

In some extreme cases, people suffering from Münchausen Syndrome acquire a high level of knowledge about the practice of medicine, and are able to produce symptoms that could result in multiple unnecessary operations. Some examples include injecting a vein with infected material, causing widespread infection of unknown origin, picking at the skin to cause ulcers, or preventing a wound from healing.

In a classic example of Münchausen Syndrome a patient was recovering from spinal surgery when the surgeon asked about the history of her amputated left leg. He found that the stump was ulcerated and inflamed. She explained to the surgeon that the amputation came about as a result of an accident in which her leg was burned. The patient eventually convinced her surgeon to amputate the leg because she believed that her leg was of little use to her.

While hospitalized, she was instructed to keep her leg elevated due to the infection and edema. However, she did not comply with instructions. When the skin grafts of her stump did not heal, a search of her room discovered that she had possession of items that would induce illnesses and a large rubber band to irritate the stump.

Münchausen Syndrome is differentiated from hypochondriasis in that patients with Münchausen syndrome are fully aware that they are exaggerating symptoms. In contrast, those diagnosed with Hypochondriasis believe they actually have a disease. Also, it is differentiated from Malingering in that the patient is motivated to assume a “sick role,” rather than an attempt to avoid some unpleasant event, such as jury duty, or court.

There also is Münchausen syndrome by proxy. When the disorder takes this form, the caretaker of a child, usually a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick. Behaviors might include adding blood to the child’s urine or stool, withholding food so the child doesn’t gain weight, heating up thermometers to make it looks like the child has a fever, or even giving the child drugs to make the child vomit or have diarrhea. In extreme cases the parent with this syndrome might go so far as to infect an intravenous line (IV) to induce illness.

Risk factors for developing Münchausen syndrome include childhood traumas, and growing up with caretakers who, through illness or emotional problems, were unavailable.

Medical professionals suspecting Münchausen Syndrome in a patient should first rule out the possibility of a physical illness.

Similar to Conversion Disorders, medical and psychiatric treatment should focus on the underlying psychiatric disorder, rather than just treating the physical illness.

Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to [email protected]