The famous German Baron von Münchhausen brilliantly understood how to gain recognition and sympathy with his invented stories. Patients suffering from Munchausen syndrome also try to gain attention. The modern “lie barons” feign illnesses extremely credibly and thus obtain sympathy, treatments, hospital stays.
Simulation of a disease
Munchausen syndrome is a serious mental illness that usually occurs in connection with a disturbed, neurotic personality development. Very little is known about its causes to date. As imaginative as Munchausen embellished his stories, these patients can be convincing with their illnesses.
The patients simulate symptoms and diseases about which they are amazingly knowledgeable. They manipulate temperature measurements and laboratory results and use a variety of tricks to convince doctors of their illness. They enrich their urine with sugar or blood to fake diabetes or kidney disease. They go so far as to cauterize their skin to fake a skin disease or swallow drugs and poison to induce bowel or heart impairment.
What are the consequences?
In addition to the injuries patients inflict on themselves, there are the side effects and dangers of the diagnostic and therapeutic procedures initiated by physicians. To clarify the “emergencies” presented, abdominal and pulmonary endoscopies are performed, bladder or heart catheters are placed, or the patient is placed on the operating table and the abdomen is opened with the suspicion of appendicitis.
Another danger is that illnesses that really occur in a patient with a known Munchausen syndrome are not taken seriously – similar to the young shepherd who twice frightened his village by warning of the wolf, only to face the wolf alone the third time because no one took his cries seriously anymore.
Just as Munchausen’s patients leave no stone unturned to force hospitalization, they are wary of being exposed: they prefer to present themselves at the emergency room at night, when no files can be procured to show their antecedents. They usually disappear quickly and secretly before anyone could make the suspected diagnosis. They change doctors and hospitals to avoid being recognized.
Is there a treatment?
The only option is psychological care. However, it can be difficult to treat such patients because their subjective level of distress may be very low, which is one of the reasons they resist treatment.
