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For the first time, the name of such a disease was used by Dr. Asher Richard, who established its presence in his patients in 1951. With Munchausen syndrome people constantly visit medical facilities unnecessarilyare deceived by their loved ones, the medical staff of the clinics. This condition is caused by severe emotional disturbances. As a rule, patients with such a diagnosis have good knowledge in the field of medicine.

Also some of them have psychological persuasion skillsthanks to which doctors are easily convinced to conduct a serious examination, a comprehensive treatment of a non-existent disease. The deception in this case is conscious, and the motivation is subconscious. Often this syndrome manifests itself in parents who impose imaginary diseases on their children, diagnose them, deliberately causing harm to health and life. The basis of such a psychological disorder is a person’s need for attention, guardianship, as well as close contact with their children and loved ones.

Causes

The causes of Munchausen's syndrome can overlap; they can only be established by a professional psychologist, psychoanalyst, neurologist.

The main causes of the syndrome are:

an acute need for attention, understanding, care, which a person cannot satisfy by other methods;
a childhood spent in an incomplete family, in which one of the parents was not able to fully spend time with the child due to increased employment or unwillingness to participate in the educational process;
youth spent in an atmosphere of emotional insecurity;
severe illnesses transferred in childhood;
problems with self-esteem;
egocentrism;
past sexual abuse;
the presence of relatives who have had serious illnesses in the past;
psychological immaturity;
lack of self-esteem;
experienced stresses;
unrealized dream to become a medical professional;
serious personality disorders.

In addition, a person with such a syndrome is much more comfortable to be in a medical facility than in his own home among loved ones. It is here that he feels protected.

Symptoms

Symptoms of Munchausen syndrome are very diverse. This and simulation of somatic or mental illnessassociated with an obsessive desire to undergo tests, risky surgical interventions, and constant complaints of poor health and weakness and, as a result, the need to constantly be monitored by doctors in a hospital.

Most patients have serious communication problems, especially with loved ones, feel the need to communicate exclusively with health workers. For them, they arrange whole dramatic performances, telling about the incurable diseases and suffering experienced by such an imaginary patient.

Patients with Munchausen syndrome are often unmotivated aggressive, their mood constantly varies from depressive-suicidal to a state of complete apathy.

They often suffer from heavy bleeding caused by the use of large quantities of drugs or chemicals used without permission.

Often people who do not find support from loved ones leave home, begin to wander around, up to complete asocialization.

The main diseases simulated by patients with the syndrome:

migraine;
skin diseases;
problems of the cardiovascular system;
problems of proctologic or gastroenterological nature;
diseases of the respiratory system;
severe diseases (tumors), etc.

Classification

The main types of this disorder:

Individual Munchausen syndrome, as a result of which the patient invents a disease at home and requires increased attention to his person.
A delegated syndrome in which parents force their children to pretend or specifically cause certain disorders in children.

Diagnostics

It is not always possible to determine the presence of Munchausen syndrome in a person after the first examination. Often, such patients, feeling suspicious on the part of the doctor, abruptly leave the medical institution and turn to another specialist. Not finding support at home, the patient may be missing. Diagnosis of the syndrome should be carried out delicately, with the direct participation of a professional. Neurologist must see the patient. Consultation with a psychotherapist will also be required, and the patient's relatives should also participate in it.

Treatment

Therapy in this case is not simple. Unfortunately, there are no effective ways to completely cure a patient. But there are a number of recommendations that should be followed.

For the treatment of the syndrome are necessary regular consultations with a psychotherapistas well as family consultations with a psychologist and participation in psychological training. The attending physician will certainly prescribe medication to correct concomitant mental disorders. If necessary, temporary hospitalization in a psychiatric hospital will be offered.

Sometimes experts use the so-called " non-confrontational approach", In which the patient is really" treated "for a non-existent disease (if the treatment does not involve medication). Massage, physiotherapy, etc. can be used.

communicate more often with people;
find a new occupation or hobby to distract from anxious thoughts;
lead a healthy lifestyle, minimize health risks;
travel;
engage in social, volunteer activities.

Prevention

Unfortunately, effective preventive measures for such a disease does not exist. Patients who are deprived of attention from relatives, lonely people, especially the older age category, are recommended to communicate more often with people, have a pet that can brighten up loneliness.

Forecast

At first glance, it may seem that Munchausen’s syndrome is not serious, since it does not affect a specific organ or system. In fact, people who have a great need for the attention and guardianship of relatives risk not only their health, but also their lives. Often in this category of patients concomitant mental disorders develop: obsessions, depressive states, loss of interest in life. As a result a person suffering from Munchausen syndrome has the following complications:

problems in communicating with people;
job loss;
financial difficulties;
loss of performance due to injuries;
organ diseases, up to disability, due to the use of heavy toxins and a large number of drugs for other purposes;
alcohol and drug addiction;
getting into an unfavorable social environment;
fatal outcome.

Parents who deliberately damage the health of their children are prosecuted, deprived of parental rights, sent for psychiatric treatment.

To provide comprehensive care for such a disease should an experienced therapist. You may need to consult a neurologist, psychologist, family doctor, who together make an accurate diagnosis, recommend treatment and will regularly monitor the condition of a person.

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Munchausen's syndrome was first described in 1951 in the UK. This disorder is still of great interest to researchers and psychiatrists around the world because of its enormous complexity and diversity, depending on what kind of disease the patient invents for himself. Moreover, pathologies simulated by patients can be both surgical and therapeutic in nature, and sometimes patients may be “required” emergency care.

Often, such patients wander from one medical institution to another for a long time in search of surgical intervention to "cure". Characteristically, the descriptions of symptoms that patients give almost always differ from real complaints in implausibility, excessive dramatization. Sometimes the stories can be similar to those legends told by the famous baron Munchausen, which caused such an unusual name for the disease. Often, Munchausen’s syndrome is called hospital addiction, occupational sickness syndrome, hospital frequent syndrome, and so on.

Entering the admission department, patients describe their complaints to the doctors who receive them as life-threatening, they complain of acute abdominal pain, loss of consciousness, bleeding, and huge blood loss. In addition, such states are described that in real life it is simply impossible to meet, but they are necessarily a threat to the life of the patient. This almost always allows you to determine that this is just a simulation of disease.

Often occurs to those doctors who are on duty at the hospital in the evening. Most likely, this is due to the fact that patients are inclined to believe that only inexperienced young specialists remain on duty at this time, who can easily not notice inconsistencies in the stories of the simulator.

Upon admission, he usually immediately begins to insist on surgery, trying to show the doctor how “bad” he is and how “his illness” is. It is usually possible to determine that the patient has Munchausen’s syndrome when examining the place where, according to him, the pain is localized. Often in this place there are many traces of surgical interventions. It is interesting that, upon hearing the doctor’s refusal to perform the operation, patients do not remain in the hospital, as required by the doctor in accordance with their “condition”, but simply leave to apply to the other hospital with the same complaints.

However, Munchausen syndrome is not always manifested precisely in the desire to undergo surgical interventions. Often the patient’s motive may be getting shelter at night, fleeing the police, getting painkillers (drugs). In accordance with this and with what disease the patient is trying to simulate, several types of disorders are distinguished. However, all people with Munchausen’s syndrome are characterized by inability to establish connections with other people, which is the reason for their loneliness, pathological deceit, hypochondria. Often, such patients, once in a hospital, begin to exert influence on other patients there, using their knowledge in medicine. is a big problem for doctors, as a patient with Munchausen’s syndrome aggravates the course of diseases of other people.

Munchausen's syndrome - a severe and chronic form of mimicking the disease - consists in the repeated production of false physical symptoms in the absence of external benefit; the motivation for this behavior is to accept the role of the patient. Symptoms are usually acute, vivid, convincing and are accompanied by a transition from one doctor or hospital to another. The exact cause is unknown, although stress and borderline personality disorder usually matter.

Symptoms of Munchausen syndrome

Patients with Munchausen syndrome can simulate many somatic symptoms and conditions (for example, myocardial infarction, hemoptysis, diarrhea, fever of unknown etiology). The patient's abdomen may be streaked with scars or a finger or limb may be removed. Fever is often the result of self-injection with bacteria; often an infectious agent Escherichia coii.Patients with Munchausen syndrome sometimes endlessly pose problems for somatic or surgical clinics. However, this disorder is a mental problem, more complex than just a fraudulent simulation of symptoms, and is associated with severe emotional problems. Patients may show signs of hysteroid or borderline personality disorder, but they are usually quick-witted and inventive. They know how to simulate a disease and are knowledgeable about medical practice. They are different from simulators because, although their deception and simulation are conscious and deliberate, their benefits are not clear, in addition to medical attention to their illness, their motivation and search for attention is largely unconscious and hidden.

Patients may have experienced emotional or physical abuse at an early age. They could also have suffered a serious illness in childhood or had seriously ill relatives. The patient gives the impression of having problems with his own identity, inadequate control of impulsiveness, insufficient sense of reality, unstable relationships. False disease can be a way to increase or protect self-esteem by condemning the failure of specialists to recognize their illness, which is often associated with observation by prestigious doctors and in large medical centers, and representing oneself in the unique, heroic role of a knowledgeable, sophisticated person in medicine.

The diagnosis is based on an anamnesis and examination, including examinations necessary to exclude somatic diseases. Less severe and chronic forms of mimicking the disorder may also include the production of physical symptoms. Other forms of mimicking the disorder may include mimicking mental (rather than physical) signs and symptoms, such as depression, hallucinations, delusions, or symptoms of post-traumatic stress disorder. In these cases, the patient also assumes the role of the patient.

In other cases, patients can produce both mental and physical symptoms.

Munchhausen syndrome by proxy

Munchausen’s syndrome by proxy is an option in which adults (usually parents) intentionally cause or mimic symptoms in a person who is under their care (usually a child).

Adults falsify the medical history and can cause damage to the child using drugs or other methods, or add blood and bacterial contaminants to urine tests to simulate the disease. The parent seeks medical help for the child and seems deeply concerned and protective. The child has a history of frequent hospitalizations, usually due to a variety of nonspecific symptoms, but in the absence of an accurate diagnosis. Child victims can be seriously ill and sometimes die.

Munchausen syndrome treatment

Munchausen syndrome treatment is rarely successful. Patients initially receive relief when their treatment requirements are satisfied, but dissatisfaction on their part tends to intensify, and ultimately they tell the doctor what he must do. Confrontation or failure to comply with treatment requirements usually leads to angry reactions, and the patient usually moves to another doctor or hospital. The patient usually refuses psychiatric treatment or tries to trick, but counseling and follow-up care can be taken at least to help resolve the crisis. However, patient management is usually limited to recognizing the disorder early and preventing risky procedures and excessive or misuse of drugs.

Patients with Munchausen’s syndrome or with more limited imitated disorders need to be non-invasively and non-punitively opposed to their diagnosis without causing guilt or reproach by identifying this condition as a cry for help. Alternatively, some experts recommend a non-confrontational approach that offers patients a way to recover from their illness without assuming their role as the cause of the illness. In both cases, it is useful to carry out the idea that the doctor and patient can solve this problem together.

Update: October 2018

It would seem that there is no such person who wants to get sick, and longer and more serious, and even without extracting material benefits from him (to get insurance or release from work, to win a court). Children who do not want to go to school and invent various manifestations of the disease do not count. We are talking about adults who simply "sleep and see" themselves in a bed in a hospital, or in extreme cases, by the bedside of a seriously ill patient (this is an extreme case specifically for a specific person with a serious condition). Psychiatrists call such people patients with Munchausen’s syndrome, they are dangerous first of all for themselves, as sometimes injuries inflicted on themselves specifically threaten life and in some cases lead to death.

According to statistics, Munchausen’s syndrome is diagnosed as 0.8 - 9% of officially registered patients, but how many people with this disorder are not taken into account? Moreover, in most cases, this disease is noted in women (95%).

Definition and history of the term

Munchausen’s syndrome is a mental disorder that is part of a group of simulated (simulated) conditions - disorders. To facilitate the concept of the term, it is necessary to separately describe the simulation and somatoform disorders.

If the patient imitates the signs of a disease, and for a specific purpose (to avoid punishment, to evade service or work) - this is called a simulation.

Somatoform disorder also refers to mental disorders, and all manifestations are associated with a real deterioration, that is, a mental disorder results in somatization. The patient has symptoms of a somatic plan (for example, pain behind the sternum, constricting or cutting, which makes angina suspected), but there are no signs of cardiac pathology in the results of diagnostic procedures (ECG, etc.).

Munchausen’s syndrome is located on the border between simulation and somatoform disorder (borderline state). That is, all manifestations of a particular disease are real and confirmed by additional diagnostic methods, however, the symptoms of the disease are specifically caused by the patient (maiming), but not to benefit, but to receive attention, care and care.

Thus, Munchausen syndrome is called borderline mental disorder, which is manifested by an imitation of the disease with its real symptoms. The goal for such patients is to conduct an extended medical examination, hospitalization and treatment, and even surgical intervention to attract increased attention to their own person.

Synonyms of this pathology:

professional patient;
munchausen neurosis;
operational maniac;
mimicking disorder;
syndrome "hospital addiction."

Origin history

This pathology got its name not from the name of the discoverer of this mental disorder of a certain Munchausen, but in honor of a literary character. Many of us are familiar with the works of Rudolf Raspe, in which the main character, Baron Munchausen, was described as a pathological liar, inventing all sorts of stories - fables in which he himself allegedly participated. Patients with this syndrome also constantly invent fables about their existing diseases in order to attract attention, but their symptoms are quite real and are caused by the patients themselves.

In the medical literature, one often encounters an erroneous opinion about the origin of the name of this disorder - in honor of the Russian officer, Baron I.K. F. von Munchhausen, a German by birth who was known for his fantastic stories about his adventures.

The name of the disease was proposed by the English doctor endocrinologist - hematologist Richard Asher. He was the first to describe in a medical journal in 1951 the behavior of patients who exaggerate or cause painful manifestations.

What leads to the development of pathology

At the heart of this mental pathology is a seemingly usual desire - to draw attention to your person. But what kind of person does not want attention and care? Unlike normal people, patients with this disorder achieve increased attention at all costs, up to taking drugs at an increased dosage and causing injury to themselves. Since Munchausen’s syndrome is a rather rare disease, the causes of its development have not been studied much, and the roots of the pathology should be searched deeper in childhood.

Currently, it is believed that Munchausen's neurosis can be observed in people with personality disorders or with schizophrenia (sluggish or mild).

The diagnosis of "Munchausen’s syndrome" to a person is based primarily on the absence of acute psychosis or signs of schizophrenia. Intentionally injuring yourself can be one of the manifestations of psychosis / schizophrenia. For example, a person in a state of severe mental disorder - psychosis, deliberately tears out his hair, cuts his skin, etc., not with the aim of attracting attention and achieving care and comfort, but with the aim of punishing himself. Otherwise, any specially inflicted injury or somatic symptom caused in full health (for example, diarrhea, as a side effect of a drug) is considered in favor of Munchausen syndrome.

The hypothesis put forward by psychiatrists explains the cause of the development of the disease by some serious problems in childhood. That is, the patient was deprived of love and attention from the parents, but suddenly received both of them only in the event of being admitted to the hospital or in any other situation related to medical care. As a result, a distorted logical chain is formed unconsciously or dimly: pain (severe symptoms) - medical personnel (doctors, sisters, nurses) - care, attention, a thorough examination - even more attention. That is, in a person with this disorder, ideas about sympathy, sincerity and mutual understanding are distorted.

Predisposing factors

A high risk of this mental pathology is inherent in people with:

psychological trauma suffered in childhood:
past sexual abuse;
severe illness in childhood and its treatment (increased care, tenderness, attention);
death of a loved one from a serious illness in childhood;
low self-esteem, inferiority complex;
unsatisfied desire to become a doctor;
hysteroid psyche;
egocentrism;
personality disorders - emotional infantilism, psychological immaturity, no self-esteem;
single-parent families (children of single mothers, fathers - widowers);
superficial attitude of parents to the child in childhood (inattention of parents, lack of time for affection);
serious stress in the past (I want pity, care, guardianship).

Case of Psychiatry

In the psychiatric literature, the story of the patient Wendy is often found, which is interesting not only by the characteristic manifestations of a psychiatric disorder, but also by the complete cure of this pathology.

The patient described throughout her life was hospitalized about 600 times, and in 42 cases she underwent surgery. Wendy very reliably described the signs of her invented diseases, so artistically depicted their symptoms that even experienced doctors believed her unconditionally.

Later, when the patient got rid of the disease, she told the doctors about her life, trying to analyze the reason that led to the mental disorder. Wendy’s childhood was difficult, she did not feel either love from her parents or care and warmth. In addition, in her childhood there was a fact of sexual violence. The only episode the patient recalled with warmth was a case of appendicitis. It was with an attack of the disease that the girl was hospitalized, where she was operated on and then received care. The nurse caring for the child sincerely worried about the girl and took care of her. It was then that Wendy felt happy and loved.

Having matured, the patient found solace, attention and care only in people in white coats. But hospital trips ended for two reasons. Firstly, the next surgical intervention ended in a serious complication threatening death. And, secondly, the girl who did not like at one time did not want to die just at that time, since a creature appeared in her life to whom she was very dear, who loved her sincerely, and who she loved very much - her cat.

Classification

There are 2 types of disease:

in fact, or the so-called individual Munchausen syndrome;
delegated Munchausen syndrome (the most dangerous).

In turn, this pathology is classified by clinical variety:

acute abdominal type (love for abdominal surgery);
hemorrhagic type;
type with neurological symptoms.

Later, others (dermatological, pulmonary and others) joined the main varieties of the disease.

Clinical manifestations

Symptoms of Munchausen syndrome are numerous and diverse, which is largely determined by the level of awareness of the clinical picture of a particular disease, the availability of a specialist of a certain profile, the ability to fantasize, imitate painful manifestations, and the ability to cause signs of the disease (for example, bleeding can only be done with blood-thinning drugs and cause diarrhea in the presence of laxatives).

Enumerate diseases that mimic Munchausen, you can endlessly. The most “favorite” pathologies by patients:

gastric ulcer and gastrointestinal bleeding;
migraine;
dermatological diseases (rash, ulcers, scratching);
diseases of the cardiovascular system (angina pectoris, myocardial infarction);
bowel disease (especially the rectum) and stomach (gastritis);
diseases of the bronchopulmonary system (tuberculosis with pulmonary hemorrhage, asthma);
acute surgical pathology (appendicitis, intestinal obstruction, adhesive disease);
tumors, including the brain.

Psychological portrait of the patient

All "barons" have inherent features of behavior and character, expressed to a greater or lesser extent:

artistry;
rich fantasy;
hysteria - attracting attention;
high intelligence;
a good education;
infantilism - emotional and psychological immaturity;
egocentrism turning into megalomania;
inadequate self-esteem (reduced or overvalued);
obsession with the idea - proof of some kind of illness;
narcissism;
tendency to hypochondria and vagrancy;
masochism;
inability to social adaptation (patients are often single, do not have a family, and if they have excellent professional knowledge, they do not advance on the career ladder);
pathological deceit;
deep knowledge in medicine (specifically by “your” disease);
lack of attention and communication;
feeling of "uselessness."

Signs indicating a pathology

Patients imitate any disease, but more often somatic. Each visit to a medical institution with a desire for hospitalization is carefully thought out and prepared. Such patients, as a rule, cause an ambulance, and do not go to the clinic for an appointment. Moreover, an ambulance is called either at night or on a public holiday, since most patients believe (unreasonably) that young and inexperienced doctors who fail to recognize their simulation will receive such duties. If the patient decided to visit the doctor of the clinic, then he pays a visit at the end of the working day, when the doctor is already tired, inattentive and guaranteed to go about the patient. If the desired hospitalization did not take place, the patient turns to another doctor, and, preferably, to another hospital. Munchausens prefer not to talk about their "hospital voyages", or are silent about the names of the doctors who were examined and about the diagnostic measures taken.

Another favorite way to attract attention is to visit doctors with regalia (I’m examined by the "luminary of medicine", since my case is very complicated). If the specialist does not confirm the simulated illness, then this serves as an excellent occasion for the patient to scandal, write complaints to various authorities, accuse medical workers of illiteracy, callousness, and inattention.

Alarming symptoms in adult Munchausen:

frequent hospitalizations:
sudden deterioration, which is not confirmed by an additional examination (analyzes, instrumental methods);
compassionate stories about their health problems;
excessive desire to undergo surgery;
vague symptoms, (at random: diarrhea is combined with numbness of the limbs and others);
persistent requests for medication (usually analgesics);
ongoing disputes with honey. employees (improper treatment, incorrect dosage, poor-quality diagnostics);
good knowledge of medical terminology.

Types of pathology

Acute abdominal or laparotomophilia

The patient “gives out” signs of an acute abdomen (tension of the abdominal muscles, peritoneal symptoms). The skin of the abdomen is mottled with numerous scars after operations. Blood tests do not confirm acute abdominal pathology.

Hemorrhagic or hysterical bleeding

Patients periodically experience bleeding, either natural or artificially created. For this purpose, patients either drink anticoagulants (gastric bleeding) or cut themselves (gum damage - an imitation of pulmonary bleeding). And they can use the blood of animals.

Neurological

Imitation of patients with acute transient neurological symptoms (seizures and paralysis, fainting and migraines, paresis and gait instability). Patients with this type of disorder often convince doctors of the need for brain surgery.

Dermatological (skin)

Intentional damage to the skin (scratching, applying lapping or masks) until purulent and non-healing ulcers occur.

Cardiac

Imitation of signs of myocardial infarction, angina pectoris, ventricular fibrillation. Distributed among mental patients, not confirmed by ECG results.

Pulmonary type

Imitation of pulmonary tuberculosis or other bronchopulmonary diseases.

Swallowing

Patients intentionally swallow foreign objects (needles, spoons, nails) in order to carry out the operation.

Mixed

It is characterized by a set of various symptoms, but in accordance with the profile of the hospital where the patient is going. A kind of mimicry for a specific medical institution.

Unusual

A rare type, characterized by casuistic cases. For example, piercing the fetal bladder in the last weeks of pregnancy to cause labor pains.

Albatross syndrome

Recently appeared variety. It appears in psychopathic patients who are “addicted” to certain medications (drugs, analgesics). Such Munchausen are persecuted by the doctor who has treated them and require them to prescribe medications or have a second operation. Distinctive complaints: persistent weakness and pain, frequent vomiting.

Delegated Munchausen Syndrome

This is an alarming and monstrous form of this mental disorder. The disease is dangerous because it is not Munchausen himself who suffers, but the man whom he made his victim. Other names for the disorders are Munchausen syndrome by proxy or Munchausen syndrome through an intermediary / representative. As the name implies, unprotected people (small children who cannot speak yet, invalids and old people) fall into the victims of the “barons”. Munchausens are the parents (often the mother), guardians and wives of the disabled, and sometimes medical workers.

In fact, this is a severe form of abuse of a ward, as a rule, with a child. One of the parents artificially and at the same time skillfully causes and induces symptoms of the disease in the baby. Complaints are made by the mother / father, who does systematic damage. Parent or guardian, they drink or administer unnecessary drugs to the ward, exceed the recommended dosage of drugs, deliberately strangle them (with a pillow, hand, plastic bag), do not rush to call an ambulance, and even introduce foreign objects into the child's body (into the stomach, colon, lungs) . Why do Munchausen parents / guardians need this? To attract attention, to create an aura of holiness and the image of a caring and attentive parent. As soon as the child falls into the hands of medical workers, parents immediately begin a "dramatic struggle for the health of the baby." Moreover, in the event of the death of the child, the mother or father initiates a lengthy lawsuit against the "werewolves in white coats."

According to statistics, among all children with sudden death syndrome (this is certainly not a diagnosis, but roughly a diagnostic dump), about 35% were victims of the "barons".

Characteristic symptoms in a child

If the child became the victim of the “baron", he has the following suspicious signs:

examination data do not confirm the presence of the disease or its severity;
preservation of complaints, despite the diagnosis, and sometimes treatment;
a rare disease that is made in the initial diagnosis;
the mother is dissatisfied with the lack of pathology, confirmed by the examination;
the parent is confidently versed in medical topics;
symptoms disappear in the absence of a mother;
treatment does not bring a positive result;
the mother does not want to leave the child even for a short time;
the phrase of an experienced doctor: "first encountered such a case."

The delegated form of the disorder is characterized by another curious sign. The clinical picture of a severe illness in a child disappears as soon as he masters the speech.

For patients with this form of the disorder are characteristic:

loneliness;
lack of attention;
conflicts in the family, lack of understanding and care;
dissatisfaction with life;
the desire to be someone needed, which translates into hyper-custody;
depressive disorders.

Unfortunately, delegated Munchausen syndrome is rarely detected. It is difficult to suspect a mental disorder in a caring, attentive and sincerely worried mother who is in good health with her child. In addition, the parent or guardian knows that if there are suspicions on the part of others about causing the ward intentional damage, they are unlikely to be voiced. Hard to prove.

But if suspicions nevertheless get publicity, patients with this form of the disorder interpret them as malicious persecution, accuse colleagues / relatives of defamation, and thus again become the focus of attention.

Case of Psychiatry

The mother came to the clinic with a one-year-old baby in her arms. According to the woman, the baby’s urine contained blood. During the examination, the woman was nearby, trying to help (or prevent?) The doctors. The mother of a sick child even carried test tubes with blood and urine to the laboratory. The obtained results confirmed that the blood of the “patient” is indeed present, although the child did not give the impression of a patient, and other tests were within normal limits. But one day, a nurse found a disconsolate mother stabbing her finger with a needle and squeezing blood into a test tube with her baby’s urine.

This is one of the mild and timely cases of delegated Munchausen syndrome. Such caring mothers bring the child to disability, and sometimes to death. In psychiatry, there are many cases of repeated deaths of children by the same mother, and even the death of the mother herself, who was killed by the rebellious daughter.

Treatment

The treatment of patients with Munchausen syndrome is a difficult task, and treatment standards have not yet been developed. The difficulty lies in the categorical refusal of patients to conduct psychiatric treatment, conflicts with psychiatrists and dissatisfaction with their work, issuing directions and making demands. Only a small percentage of "barons" voluntarily agree to psychotherapy.

devote one doctor to the problem, build trust with him;
expand the circle of friends (make friends, acquaintances, try to “grow” friends)
get involved in a new occupation / hobby;
adhere to a healthy lifestyle;
become a volunteer or public figure;
have a pet.