Munchausen syndrome

Psychologist Dr. Doping tells about the difference between simulation and factitious disorders, incorrect term and delegated disease.

Munchausen's syndrome is a mental disorder from the group of simulation or simulated disorders. But in order to more clearly understand what it is, it is necessary to differentiate right from simulations and so-called somatoform disorders. Simulation - it is an imitation of a disease with a specific purpose and a specific motivation: to avoid punishment, failure to service, work or in some other gain. Somatoform disorder - a mental disorder, and as the name implies, in the form of somatic it. The classification of DSM-5, it is called a "mental disorder in the form of somatization". That is, the patient has any symptoms of physical plan, but for them there is no sufficient explanation from the physiology and anatomy of the body. For example, he observed some strong pain in the heart, but an electrocardiogram and other cardiological examinations indicate that the patient's heart healthy.

Munchausen Syndrome occupies an intermediate position between the two concepts. On the one hand, the symptoms that are observed in these people are real, that is some real physiological changes in the body. On the other hand, they are caused by this patient intentionally, but, in contrast to the simulation, without any particular motive and the purpose of receiving material benefit or avoidance of some social demands.

Thus, Munchausen's syndrome is a factitious disorder, and it is manifested in the fact that the patient deliberately does himself any injury, intentionally causing themselves physical range of symptoms, ie, symptoms associated with the body's suffering. But not in order to escape punishment or to avoid the social demands, but for other reasons. And this is the most interesting in Munchausen's syndrome, because, according to current observations, the main reason - is the motif of getting attention and extra care of yourself.

History of the term - Munchausen Syndrome

In 1951, psychiatrist Richard Asher first described the disorder as an independent and suggested this name. Usually in psychiatry, as in principle in medicine, the name given in honor of the one who discovered the disorder, or if some famous people have suffered from this disease, or as a metaphor. But no Munchausen disorder did not open, and a real person with that name was not in the story. In this case, the third option, that is a metaphor.

Asher suggested calling this disorder is so because a famous literary character by the name of Baron Munchausen famous for having invented all sorts of stories to draw attention to himself. And Munchausen syndrome patients come up with different stories to attract attention, but their stories - this is not a fantastic story about a flight to the cannonball, or pulling themselves out of the swamp by the hair, and that somatic symptoms that they have themselves caused.

Now there is a big debate: The American Psychiatric Association has decided not to use the term "Munchausen syndrome", and replace it with the term "factitious disorder." Because all the same for people who suffer from this mental disorder, atypical humor, absurd fantasy, fiction, fiction. And so the old name for this syndrome, according to the American doctors can show disrespect to such patients.

Of course, these patients met before, but they were first systematically described and drew the attention of somewhere in the middle of the XX century.

Causes of disease

Reasons syndrome deeper than a simple desire to attract attention, but they are not well understood, because it is not the most common mental disorder. Patients come to the attention of professional psychiatrists and psychologists are not always. Now it is believed that this syndrome, which can occur for various mental illnesses, primarily in personality disorders and mild forms of schizophrenia, while creeping schizophrenia. To reduce schizophrenia and improve brain functions we suggest to buy: Cortexin, Phenotropil, Selank, Peptides Pinealon, Cogitum, Phenibut, Picamilon.

As diagnostic criteria to diagnose "Munchausen syndrome" in humans should not be acute psychosis and acute schizophrenia, because then it is a manifestation of other diseases. But if these conditions are not observed, and there are some criteria that applies a Statement of various injuries or induction at different somatic symptoms, while the doctor, there are suggestions that the patient is doing so in order to get the attention, then he put diagnosis of "Munchausen syndrome".

Why is this happening? Why do these people show their personality disorder in this way? There is a hypothesis that as a child they had some kind of trauma, they were deprived of the care and love, and at some point unconsciously discovered that receive care, love and attention that they do not have, can only medical care situation . And they half-consciously or unconsciously begin to make these procedures are: can be consumed any drugs that cause their side effects, can cause himself any injury. And all this leads them to a hospital, where doctors and medical staff immediately begin to care for the patient, give him a lot of attention, to understand, what is this strange symptoms, which, generally speaking, for this patient should not be characteristic.

Classification of Munchausen Syndrome

There are two major types of Munchausen syndrome. Firstly, the actual Munchausen syndrome, is factitious disorder or when the person is at some physical symptoms and goes to the hospital with them.

Secondly, the so-called delegated to Munchausen syndrome, or 'Munchausen syndrome by proxy. " Then the patient is not at the symptoms, and in some other person dependent on him, and who is actually in a state of helplessness. Usually it is the mother, the woman who deliberately cause symptoms in a child with him come to the doctor, and doctors trying to help him understand what happened, examined him. In this situation, a sick woman receives care and attention, there is some reduction in her stress level.

It is known that a delegated form of Munchausen syndrome is mainly in women, and the usual form, when a man makes himself the symptoms are equally present in both men and women. Even there is evidence that in men is more common.

Diagnosis and exposure of Munchausen Syndrome

Of course, the ability to see the symptoms of this syndrome depends on the physician's experience. If a person complains of symptoms makes them very dramatically, he says how much he is suffering, but these symptoms are actually not so difficult, it is about something said. The patient may be poisoning may be some numbness, diarrhea and other symptoms, which are usually interconnected in such a ratio is not found. That is, a person strange set of symptoms and objective survey say that everything seems to be okay, but the patient complains and dramatically describes his experiences. This behavior should attract the attention of the doctor, because it is not present, the disease, which he, as a therapist, and physical medicine doctor, should be treated. Rather, it is something from the field of mental disorders: somatoform disorder, or malingering or Munchausen syndrome.

If the patient has no motive to imitate the disease, that is, the patient is a young man who wants to avoid the army, then the doubt doctors are reduced to the question: is somatoform disorder or factitious disorder? And then, of course, is necessary to understand, because of somatoform disorders have a separate classification. And if a somatoform disorder does not fit, then it is necessary to understand and to think that this is likely, it is about Munchausen Syndrome, especially if there are records that the patient is periodically supplied with some very diverse symptoms (ie injury, the poisoning and so on) in the same clinic, located for example in the area of its residence. These records indicate immediately that if the symptoms are different and the person goes to the hospital very often, then it probably is Munchausen syndrome.

Denial and disease progression

Some people fail to realize that they are sick. Their self-injurious behavior, aimed at evoking the symptoms are not well reflectors. For them, it's a habit, impulsive compulsive actions. Even the part that they have recognized, can very rapidly be displaced into the unconscious, because it causes a very strong shame in the patient in the knowledge that he is capable of doing such things. Therefore, patients are usually poorly reflective, what happens to them.

The syndrome progresses so that patients are increasingly coming to the hospital. If this is a delegated form of factitious disorder, at some point in medicine there is a request to the law enforcement agencies, because the child suffers and there is evidence that he bring harm. By then it may be assigned by the court for compulsory treatment and any limitations on rights and freedoms. And if it is an independent factitious disorder that occurs in one person, in the best case it will be referred to a psychiatrist in a relatively compulsion, and a psychiatrist with him to communicate. And in the worst case, he can get any serious injury or even death from what he is doing. Therefore, medicine relates closely enough, if it detects that a particular patient is characterized by self-destructive actions, which means it can cause self-harm and potentially dangerous to himself. Early prevention of this disease is almost impossible.

Therapies

In psychiatric hospitals, such patients are extremely rare. Treatment may be different. It may be, for example, psycho-pharmacotherapy. In the literature, there is a view that selective serotonin reuptake inhibitors are effective for the relief of these states. And, of course, there are methods of treatment with the help of psychotherapy, beginning with family therapy and ending with a psychotherapy, which aims to address the problem, that is, when the therapist tries together with the patient to find ways of getting care, attention and love by some other means, which are not associated with auto-destruction and auto-aggression. But it works only if the patient is configured to solve this problem, if it recognizes that a problem in that it is the disease and the patient suffers from it.