Munchausen Syndrome

March 21, 2021

3 min read

Munchausen syndrome is a psychological disorder in which a person pretends to be sick. Someone with this condition might also deliberately do things to produce symptoms of an illness. The condition—named after a fictional character who repeatedly makes false and exaggerated claims—occurs when people attempt to assume a "sick role," often out of a complex and strong desire for attention and sympathy. Here are five important things to know about this syndrome.

1. People with Munchausen syndrome do a variety of things to assume the sick role.

It can be difficult to spot someone with Munchausen syndrome. Generally speaking, someone with Munchausen syndrome will:

Lie about their symptoms
Tamper with test results (e.g., add blood to a urine sample)
Complain about symptoms that are difficult to disprove (e.g., severe headaches), vague, do not match test results, or get worse for no apparent reason
Exhibit self-inflicting behaviors (e.g., cutting, eating contaminated food)
Aggravate conditions (e.g., rubbing feces into wounds)
Have good medical knowledge
Tell outlandish or unbelievable stories about their past
Frequently visit the hospital or go to multiple different hospitals and medical providers

People with Munchausen syndrome are often adept at lying and can be very convincing. They often end up receiving treatments or undergoing procedures as a result of their fabrication.

2. Doctors are still learning about why Munchausen syndrome happens.

As is true for many psychological disorders, we don't always know why some people develop Munchausen syndrome. It appears to be more common in women between the ages of 20 and 40, and especially in women who work in the medical field. Unmarried middle-aged men also appear to be more likely to demonstrate Munchausen syndrome, although it can occur in people of any age or background.

Many people with Munchausen syndrome have a history of childhood trauma. They may have had a real chronic illness as a child that required extensive medical treatments or prolonged hospitalizations—which garnered them a lot of attention as a result. Research also suggests that other psychological conditions, including depression, posttraumatic stress disorder (PTSD), antisocial personality disorder, borderline personality disorder, and narcissistic personality disorder, are associated with an increased risk of Munchausen syndrome.

Brain imaging studies of some people with Munchausen syndrome also point to some structural differences, so there could be genetic or biological factors at play, too.

3. Munchausen syndrome is different from malingering, in which a person feigns illness for personal gain.

Munchausen syndrome is known clinically as factitious disorder and is included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It's different from malingering, in which a person fakes an illness for some sort of personal benefit, such as economic gain or avoidance of legal responsibility.

In order to be diagnosed with Munchausen syndrome, a person must fulfill the following three criteria:

1.
They intentionally produce or feign their signs and symptoms of illness
2.
Their primary motivation is to assume a sick role
3.
They must not have any external incentives for their behaviors

4. Some people fake or induce an illness in someone else who is under their care.

In rare cases, a person fakes or induces an illness in a child or someone else under their care. This is known as Munchausen syndrome by proxy and is considered a form of child abuse or elder abuse. People with Munchausen syndrome by proxy will lie about their loved one's symptoms, tamper with test results, or in some cases physically harm their loved one in order to produce symptoms of an illness.

5. Treating Munchausen syndrome is difficult.

Munchausen syndrome is treatable with things like cognitive behavioral therapy, but treatment success largely depends on a person's willingness to admit they have a problem and are lying about their illness. Unfortunately, recovery from Munchausen syndrome is often slow, if recovery occurs at all.

Many people with Munchausen syndrome are estranged from their families and have no close loved ones. However, if they are still contact with family members, then family therapy might be helpful, too, especially when it comes to teaching family members how to avoid reinforcing the person's "sick role" behaviors.

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