Munchhausen's syndrome

Munchhausen Syndrome is the intriguing name of a very rare borderline psychiatric disorder. The essence of this disease consists in an obsessive desire to be treated. From everything and where possible. The main goal of people with Munchausen's syndrome is to achieve hospitalization in any hospital by any means. To do this, they resort to a variety of actions: they injure themselves, swallow foreign objects( spoons, barrettes, etc.), take medications and, of course, lie to doctors. However, the simulation does not have any delayed purpose( for example, shirking from work or obtaining a certain medical opinion).Patients with Munchausen syndrome do all this just for the very fact of treatment. What is this disease, why it arises, how it can manifest itself and how to fight it, we will try to understand this article.

Contents

1 A bit of history
2 Causes of
3 Symptoms of
4 Delegated Munchausen syndrome
5 Diagnosis and treatment of

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A bit of history

Munchhausen's syndrome was first described by Dr. Richard Asher in 1951 in a patient obsessed with a passion for treatment. The name was given in honor of the great dreamer of the German baron Munchausen, who became a hero of literature, thanks to his phenomenal abilities to fiction. This is what distinguishes all patients with this syndrome. In their irrepressible desire to be treated, they resort to such sophisticated tricks that are not always recognized by medical staff. As a result, patients with Munchausen's syndrome find themselves on a hospital bed, achieving the desired, and sometimes on the operating( !) Table. In medical practice, the case of Munchausen syndrome is described, when the patient 40 times got on the operating table, absolutely not needing at the same time in surgical intervention( she so talently simulated the necessary symptoms for this).

Reasons for

To date, Munchausen's syndrome is one of the manifestations of hysteria. It is believed that the source of this condition are the numerous psychological problems of childhood. Most often, Munchausen's syndrome occurs in people who were not loved enough in childhood by parents, grew up in an incomplete family, and had a lack of attention. If you dig in the past such patients, it is often found the fact of some disease, after which the family paid more attention to the child than usual. And then in the head of a small child a stereotype was formed: that you are loved more, it is necessary to get sick. And this stereotype is transferred to adulthood.

People with certain personality traits are inclined towards Munchausen's syndrome, such as selfishness, egocentrism, a tendency to demonstrate. They are characterized by a high level of anxiety, an overestimated or underestimated self-esteem, they are often socially maladjusted and, being already adults, can not create their family in any way. More often the syndrome occurs in females. Men with this syndrome are prone to aggressive behavior.

Another peculiarity peculiar to patients with Munchhausen syndrome is their rather high intellectual level. These people, before seeking medical help, study medical literature, carefully forming the history of their illness. They think over everything in detail, so as not to be caught unawares and not be recognized in their lies. It can even be health workers who have free access to medicinal substances and appropriate vocational education. Partly, therefore, such patients manage to deceive even competent doctors with experience. When exposed, patients with Munchausen's syndrome always behave extremely emotionally, categorically deny the "fictitiousness" of their symptoms and even threaten the doctor. Not having received the desired in one place, they are sent to another medical institution. And so history repeats itself many times.

Symptoms of

The pathological manifestation of Munchausen's syndrome is the appropriation of a disease. That is, in fact, there is no disease, and it is well known to a patient with Munchausen syndrome. But by all means he should convince in the presence of illness of medical staff and associates. For this, all the acting skills will be used. It is simply impossible to describe all possible symptoms of Munchausen's syndrome, because they can be any, as far as the imagination and sophistication of the mind are enough for the patient.

Still, it is possible to list the most common "diseases" with which "munhhausen" get to a medical institution. These are the situations:

bleeding from a wide variety of locations. Patients injure their gums to truly represent hemoptysis, damage the anus and the tissue around it so that one can talk about intestinal bleeding. Sometimes for these purposes, paint or animal blood may be used. And some patients specifically take drugs that help reduce blood clotting capacity, thereby provoking the development of bleeding;
syncope and epileptic seizures. This, perhaps, is one of the most favorite actor's representations of patients with Munchausen's syndrome. And fainting, and all kinds of epileptic seizures are portrayed so plausibly that they are almost never recognized as fake. In severe cases, it comes to the fact that patients provoke the onset of a true fainting or seizure by taking medications, because then the mosquito will not be completely eroded, and no one will doubt the authenticity of the disease;
acute abdomen and other abdominal problems. Cause nausea and vomiting? No problem! Simulate abdominal pain? It's as easy as that! Or, for example, you can artificially cause diarrhea( the arsenal of laxatives in the pharmacy is quite wide).And even better - all at once, because then, for sure, will be left in the hospital! This is exactly what patients with Munchhausen's syndrome are striving for;
injury. There is already a place where you can make a fool of a sick fantasy. What kind of damage do not the patients themselves cause? And most often the injuries themselves and wounds are insignificant and not at all dangerous, but there is heavy bleeding( for this, using foreign blood or paint) and a strong pain syndrome with an appropriate emotional color. In some cases, patients can themselves amputate a finger or even a limb;
skin diseases. To simulate dermatological problems, patients with Munchausen's syndrome smear themselves with ointments and creams, strip nettles, expose themselves to insect bites, infect infection into minor wounds on the skin, and so on;
increase in body temperature of unknown origin. To do this, patients inject themselves with a syringe lyophilisates of bacteria.

A characteristic feature of the "munchhausen" is the multiplicity of symptoms, that is, their number can grow exponentially( especially if the patient feels the doctor's doubts about the truth of the disease).Such patients wish to be initiated into all details of their condition, in the fineness of the examination, and sometimes even come to the doctor with advice on how to treat them. If the deceit is not revealed, then the patient with Munchausen's syndrome has a higher self-esteem. After all, he was able to deceive the doctor! And the more titled the doctor, the more unique and talented the patient feels. Other patients prefer younger, inexperienced doctors working on weekends or at night, because they feel that they are easier to deceive.

If you can not deceive doctors, then after categorically denying your simulation, statements about the incompetence of the corresponding doctor in charge, the patient with Munchausen syndrome is retired. However, after a while it appears in another medical institution with a new script. And so it can last a lifetime. Endless circles of walking around hospitals...It is interesting that abroad such people who constantly seek medical help on various occasions are brought into a computer base, which is accessible by any medical institution. If a doctor has any doubts about the veracity of the symptoms, sometimes this database allows to expose the patient. But in cases where emergency medical care is required and there is no time to look at this database, this method of registering patients does not work.

Delegated Munchhausen syndrome

There is a separate type of Munchausen syndrome, which is called delegated. This is the most dangerous situation, because in this case the picture of the disease is reconstructed not by the patient himself, but by his ward( a close relative, a disabled person or a child).In such cases, "munchhausen" harm the health of a loved one, which can end very tragically. Children can not feed or feed deliberately spoiled food, give unnecessary medicines or incorrect doses, even can prevent breathing, covering the head with a pillow or covering the nostrils with fingers."To catch on hot" the patient is not always given the opportunity, which aggravates the situation.

Deliberate actions are taken in order to subsequently care for the now sick child or relative, thus attracting more attention, and sometimes praise for the firmness of spirit and dedication. In the main, Munchausen syndrome is developed in single women with depressive episodes. To suspect delegated Munchausen syndrome is often even more difficult than usual. After all, to declare in vain about such deliberate actions, and even in the absence of evidence, having only speculation, not everyone will decide. And "munchhausen" in such cases will set the people around against the one who expressed such absurd, seemingly suspicious. And still it is not known, whose arguments will be more convincing.

Diagnosis and treatment

Diagnosis of Munchhausen's syndrome is quite complicated, because there is no algorithm for the actions of a doctor in such cases. Suspicion should occur when additional( objective, so to speak) research methods do not show any changes on the part of the body. That is, no pathology is found, but a coma of complaints grows and grows. But, unfortunately, this is not always possible. After all, a patient with Munchausen's syndrome can have real health problems, which he exaggerates. Or he can use medicines that will change the indicators during the examination, after all "munchhausen" quite professionally approach to the preparation of their "disease".

Treatment of Munchausen's syndrome is no less difficult than diagnosis. The situation is caused by the lack of criticism to their condition in such patients, and hence the understanding of the need for treatment."Munchhausen" do not recognize their illness, so in most cases, if the disease can be diagnosed, treatment is limited to restricting medical interventions( especially surgical ones), stopping inpatient treatment. If a psychiatrist or a psychotherapist can find the key to the patient, then rational psychotherapy is possible. However, it is rarely effective. Most often, after a while, patients with Munchausen's syndrome are mistaken for their: once again they begin to wander around the medical institutions with other fictions.

In some cases, the appointment of antidepressants or antipsychotics( depending on the psychological background of the disease) facilitates the patient's condition. But since it is impossible to force one to take medicines of such patients, most often these attempts to get rid of the disease are unsuccessful.

Another approach to the treatment of such patients is the appointment of a placebo, that is, pills-pacifiers. After all, patients seek treatment, in which case they find it and calm down for a while. Not all doctors consider this approach to be justified, because this is an indulgence of the disease, but sometimes this method allows you to suspend a series of medical adventures.

In general, it can be said that Munchhausen's syndrome has not yet been treated. There are currently no effective methods of treatment with an appropriate evidence base. The only thing that pleases is that patients with Munchausen's syndrome do not meet very often. But let us hope that the development of science will allow us to find a government for this disease in the future.

Thus, Munchausen's syndrome is a rare psychiatric problem when a patient thinks up or embellishes the symptoms of a disease trying to convince others in his presence. The disease is difficult to suspect and diagnose, and even harder to fight with it. Getting rid of Munchausen's syndrome is the task of the future.

Radio channel "Says Moscow", program "Together with a psychologist" on the topic "Lie or Munchhausen syndrome?":

Munchausen syndrome: Damian Sinai( psychologist) 10/14/2015 - # GOVORITMOSKVA