Munchausen Syndrome

Munchausen syndrome (the syndrome of Baron Prášil) is a mental disorder. It belongs to the group of factitious (pretensive) disorders.

The disease presents through feighning of somatic or psychological issues, the purpose of which is unclear. Most commonly it is interpreted as an attempt to assume the role of sick to get in contact with the medical personnel.

Epidemiology
From the point of view of prevalence, the disease belongs to  rare conditions. Worldwide, individual cases are described in case studies. Several cases have also been reported in the Czech Republic.

Sings
It can manifest itself by a whole range of symptoms  – from simple feigning of pain to direct induction of patology which can have lethal consequences. The affected individuals typically visit multiple medical facilities, complaining about problems that are difficult to expain though performed exams. To keep the pretence, pacient can for instance add blood into urine, pinch themselves with needles or apply dirt or even feces into their veins veins.

Therapy
Therapy is not easy. The disorder tends to become chronic. Bothe psychotherapeutic and pharmacotherapeutic approaches are important and the treatment should be conducted by and experienced psychiatrist. The problem is that the affected inidividuals would not understand that they need treatment.

Differential diagnosis

 * First it is necessary to exclude somatic disease.
 * The difference between simulation and pathology is that the real pathology cannot be consciously manipulated.
 * VThe differentional diagnosis includes schizophrenia spectrum disorders, but in that case the symptoms would be accompanied by the apparent defect in thinking or perception.

Munchhausen syndrome by proxy
It is a variant in paediatrics, where the caregiver (most often the mother) pretends that their child is sick, worsens the existing condition nebo induces pathologies in the child, which make them search medical aid and request diagnostic and therapeutic intervention.

Typical signs

 * The child’s illness is multi-systemic, chronic, unusual or rare.
 * Symptoms are disproportionate or incongruent.
 * Symptoms disappear in absence of the parent/parents.
 * The was an occurrence of sudden infant death syndrome in the family.
 * The child responds to the therapy in an unusual way.
 * The parent is closely attached to the child and has medical knowledge.
 * The parent urges the medical staff to perform further exams on the child.

Therapy
The child must be protected from harm! Often, it is necessary to remove the child from their parents' custody. In the cases where child health had been compromised, the persons responsible faced criminal charges. Cases ending in death are also known.

External sources

 * Munchausen syndrome on wikipedia
 * Karl Friedrich Hieronymus von Münchhausen