by Kimberly Allen R.N.
Munchausen syndrome, a psychiatric disorder also know as factitious disorder, is a condition where a person intentionally fakes the symptoms of illness in order to become a medical or hospital patient. Unlike hypochondria, where a person has an exaggerated fear of becoming ill, the Munchausen patient will go to great lengths to be ill. They will self inflict injury or purposely induce an illness so that they require hospitalization. The person with Munchausen will spend years traveling from doctor to doctor and hospital to hospital seeking treatments. He or she will undergo unnecessary and invasive procedures including surgery to maintain their role as a medical patient. If confronted about their “illness” they usually move to another town or state and different doctors and hospitals.
Soon after I started working as a home health nurse I received a telephone call from a social worker from a hospital in another state informing me that a woman receiving TPN (total parental nutrition) through a central venous line was moving into our area and that she would require home nursing and medical equipment/supplies. I made the necessary calls for the equipment including the TPN in preparation for her arrival. She and her husband arrived 2 days later. I went to their home to do the assessment and admission to services. When I arrived, I found a frail appearing woman that was very pleasant, but very concerned about her health and how much care she could receive. When I asked about her medical history I should have realized something was wrong when she pointed to a rather large box and said, “everything is in there” – she carried her medical records with her. She even had copies made for me to read through. I took the files back to the office and began to read. In the mean time, records that I had requested from the social worker had arrived. I was absolutely stunned as I read the number of surgeries this woman had endured. None of the procedures or treatments this woman had received were pleasant and now she was being fed through a tube going into a vein in her upper chest near the heart called a CVP line. A CVP line requires very special care because it’s so close to the heart and the risk for infection and complications is significant. Shortly after admitting her to home care she began to run a low grade fever so she was admitted to the local hospital where she stayed for several weeks. While she was in the hospital I continued to read through the information the social worker had sent and that’s when I encountered the term Munchausen syndrome for the first time so I looked it up in my medical dictionary. I had never heard of a person going to such lengths to be a patient, I knew that there were people that feared illness but wanting to be sick? This woman had been in at least 6 different hospitals in 4 different states, and I didn’t try to count the number of doctors she had seen.
The cause of Munchausen syndrome is unknown though there are a variety of theories. There’s almost no data available as to the cause or even how prevalent Munchausen is because people with Munchausen have mastered manipulation and are not honest about their illness and are frequently successful in fooling their health care providers.
Munchausen by proxy is a condition similar to Munchausen except that it refers to a caregiver, usually a parent, that purposely causes another person, usually a child, to become ill. In Munchausen by proxy the caregiver will insist on staying with the person that is “ill” in the hospital. There have been cases where a parent intentionally made a child ill, appearing to have symptoms of cancer and putting the child through chemotherapy as well as numerous surgeries to gain sympathy and attention. People with Munchausen or Munchausen by proxy crave the attention received be being either ill or the caregiver of someone that is severely ill.
Treatment is nearly impossible, as the person with Muchausen almost always refuses to admit there’s a problem and if a psychiatric evaluation is suggested they outright refuse it and usually move on to a new doctor, new hospital and new town. If you suspect a friend or family member of suffering from Munchausen or Munchausen by proxy, tell a doctor or social worker right away.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.