A healthy living blog from Marshfield Clinic

The mystery of Munchausen syndrome

young teen with headache / nurseMunchausen syndrome is a condition where a person behaves as if they have an illness when they actually do not.  Munchausen by proxy is a syndrome where people falsely claim that someone in their care has an illness. In recent years, Munchausen syndrome has been renamed factitious disorder. In some cases of factitious disorder, the person will have symptoms of an illness, but has caused those symptoms themselves by self-inflicting an injury or illness.

Different from malingering

“The thing with factitious disorder is that the people who are displaying these symptoms don’t really know why they’re doing it,” said Dr. Justin Schoen, a Marshfield Clinic Health System psychiatrist. “This is different from malingering in which people create false symptoms but do so for some kind of known gain, like seeking certain medications, getting out of work or avoiding punishment.”

Who is most likely to develop it?

Schoen said little is known about why people develop factitious disorder. Some people may have a psychological predisposition to the disorder and/or a previous traumatic event may contribute to developing it. There is not a good understanding as to whether there is a biological basis for factitious disorder.

Schoen said people with personality disorders or depression are more likely to develop factitious disorder. He added that people who work in health care also are more likely to develop this disorder.

“It may be because health care workers have a knowledge base. They may be more likely to think something is medically wrong with them,” Schoen said. “People who had a serious illness in childhood also are more likely to develop factitious disorder.”

Identifying factitious disorder

Schoen said there are a few telltale signs that someone is displaying factitious disorder:

  • They know an unusual amount about their supposed medical condition.
  • They give vague or inconsistent responses about their symptoms.
  • They’ll jump around to different health care providers and facilities.
  • Diagnostic tests don’t validate what the patient is saying.

Schoen added that surgical scars also could be a sign of someone with factitious disorder.

“A person with factitious disorder might for example be reporting abdominal issues and no underlying cause is being found, so an exploratory surgery is done,” Schoen said.

In terms of treating someone with factitious disorder, Schoen said it is first important for the medical team to identify it. Then, the medical team can ensure the patient does not receive any unnecessary treatments. In addition, talk therapy can be helpful for patients in treating factitious disorder.

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