Munchausen syndrome on self and others

Munchausen`s syndrome is a factitious psychological disorder whereof  the patient repeatedly pretends to be ill and make medical emergencies to be able to stay in hospital and seek medical care, without any secondary gains. They fabricate their signs and symptoms and some also fake laboratory tests (Pankratz, 1981). 

There exist little research on the syndrome, as cases are rarely diagnosed and reported. However there has been reported to be more present in males over females and in most cases it occur in the first years of adulthood and after an already episode of hospitalization The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) defines factitious disorders (Munchausen and Munchausen by proxy) as those patients imposing on self and others. Nevertheless their do not exist any diagnostic criteria and cases are often not identified my health professionals, as a result of lack of research and knowledge (Filho et al,. 2017).

Munchausen by proxy is when parents falsification psychical or psychological signs and symptoms of their child. This is a serious form of child abuse and reports has increased over recent years. The parent, in most cases the mother persistently takes her/his child to seek medical care. Further on the illness need to be a result of a deception (fraudulent behavior) and be presented to someone else. In addition the behavior still occurs, even with the absence of external reward and the symptoms of the child sometimes abate whenever the child is separated from the perpetrator (Filho et al,. 2017). 

There do not exist a clear etiology of the understanding of Munchausen syndrome. However some authors state for instance psychodynamics and social history reasons. As a result of many patients have experienced loss, rejection or sadism by their parents or history of being hospitalized. Furthermore some researchers have found out that the syndrome can be a result of drug abuse, mood disorder or a personality disorder, more specifically antisocial, passive-dependent, histrionic or border-line personality disorder (Pankratz, 1981). Nevertheless another reason behind it can be explained by developmental and characterological factors or as a result of brain dysfunction. 

Case study 1
A 9 years old boy was staying in long-term psychiatric hospital as a result of acute psychosis. After 8 mounts under super vision he admitted to having played a long with his own mother for medical hospitalization. 

Case study 2
One of the most famous and awful examples of Munchausen by Proxy was convicted by Dee Dee Blanchard, mother of a girl named Gypsy (born 1991). Throughout her life she was forced to be seated in a wheel chair and  believed to be suffering from muscular dystrophy, impairment and seizures in her and hearing and leukemia. She had almost never been outside her house as she spend most of her childhood in hospitals. In addition she had to use a breathing machine and was given a lot of medicine (resulting in rotting her teeth’s), despite not being sick. In 2015 Gypsy and her boyfriend killed her mother and was sentenced to prison. 

                                      References:

Filho, Kanomata, Feldman & Neto (2017). Munchausen syndrome and Munchausen syndrome by proxy: a narrative review. SciFlo Brasil: 

Pankratz, L. (1981). A review of the Munchausen syndrome. ScienceDirect: https://www.sciencedirect.com/science/article/abs/pii/0272735881900192