Munchausen Syndrome (Factitious Disorder)
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Basics
Description
- A disorder in which the patient fakes signs or symptoms without tangible personal benefit other than to experience the sick role
- Referred to as factitious disorder in the DSM-5
- The nature of the disorder resists rigorous study and prevalence is unknown but possible risk factors include:
- Males
- Unmarried
- Age in the thirties/forties
- Personality disorder
- A history of sadistic and rejecting parents
- A history of chronic childhood illness
- A history of employment in the medical field
Etiology
- Factitious disorder:
- DSM-5 diagnostic criteria:
- Intentional production of physical or psychological signs associated with deception
- Patients presents as ill, impaired, or injured
- Absence of external incentives
- The behavior is not better explained by another mental disorder
- DSM-5 diagnostic criteria:
- Onset is usually early adulthood often after hospitalization for a mental disorder or medical condition
- Clinical clusters:
- Self-induced infection
- Simulated specific illnesses with no actual disorder
- Chronic wounds
- Self-medication
Pediatric Considerations
- Munchausen by proxy (Factitious Disorder Imposed on Another):
- The patient's illness is caused by the caregiver, not the patient
- The motivation for the caregiver's behavior is to assume the sick role by proxy
- The caregiver inflicts injury or induces illness in their charge, usually a child
- Commonly parents (mostly mothers)
- May simulate injury and disease in a number of ways:
- Inflicts injury
- Induces Illness
- Fabricates symptoms
- Exaggerates symptoms of the child's illness causing overaggressive medical interventions
- The perpetrator usually refuses to acknowledge the deception
- Cessation of the symptoms when the patient and caregiver are separated
Geriatric Considerations
Caregivers of elderly patients may also be perpetrators in Munchausen by proxy
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- A disorder in which the patient fakes signs or symptoms without tangible personal benefit other than to experience the sick role
- Referred to as factitious disorder in the DSM-5
- The nature of the disorder resists rigorous study and prevalence is unknown but possible risk factors include:
- Males
- Unmarried
- Age in the thirties/forties
- Personality disorder
- A history of sadistic and rejecting parents
- A history of chronic childhood illness
- A history of employment in the medical field
Etiology
- Factitious disorder:
- DSM-5 diagnostic criteria:
- Intentional production of physical or psychological signs associated with deception
- Patients presents as ill, impaired, or injured
- Absence of external incentives
- The behavior is not better explained by another mental disorder
- DSM-5 diagnostic criteria:
- Onset is usually early adulthood often after hospitalization for a mental disorder or medical condition
- Clinical clusters:
- Self-induced infection
- Simulated specific illnesses with no actual disorder
- Chronic wounds
- Self-medication
Pediatric Considerations
- Munchausen by proxy (Factitious Disorder Imposed on Another):
- The patient's illness is caused by the caregiver, not the patient
- The motivation for the caregiver's behavior is to assume the sick role by proxy
- The caregiver inflicts injury or induces illness in their charge, usually a child
- Commonly parents (mostly mothers)
- May simulate injury and disease in a number of ways:
- Inflicts injury
- Induces Illness
- Fabricates symptoms
- Exaggerates symptoms of the child's illness causing overaggressive medical interventions
- The perpetrator usually refuses to acknowledge the deception
- Cessation of the symptoms when the patient and caregiver are separated
Geriatric Considerations
Caregivers of elderly patients may also be perpetrators in Munchausen by proxy
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