Munchausen Syndrome: A Systematic Review
Abstract
Munchausen Syndrome is a rare form of mental illness characterized by a person’s intentional fabrication of symptoms in order to gain medical attention. It is a serious condition that can have a great impact on a person’s life and the lives of those around them. This systematic review aims to provide an overview of the current literature on Munchausen Syndrome, with a focus on the epidemiology, diagnosis, and treatment of the disorder. The review also looks at the implications of Munchausen Syndrome, such as its impact on healthcare costs and the implications for the patient’s family and friends.
Introduction
Munchausen Syndrome, also known as Factitious Disorder Imposed on Self (FDIS), is a rare form of mental illness characterized by a person’s intentional fabrication of symptoms in order to gain medical attention (Gaw and Green, 2002). It is a serious condition that can have a great impact on a person’s life and the lives of those around them. The prevalence of Munchausen Syndrome is difficult to ascertain due to the secretive nature of the disorder, but estimates range from 0.2 to 1.0% in the general population (Gaw and Green, 2002).
The disorder was first described in 1951 by German physician Richard Asher, who based his description on the story of Baron Munchausen, a character from German folklore who exaggerated his own experiences (Gaw and Green, 2002). Since then, there has been an increasing interest in the disorder, with numerous studies being conducted to better understand it. This systematic review aims to provide an overview of the current literature on Munchausen Syndrome, with a focus on the epidemiology, diagnosis, and treatment of the disorder. The review also looks at the implications of the disorder, such as its impact on healthcare costs and the implications for the patient’s family and friends.
Methodology
A systematic search was conducted using the following databases: MEDLINE, PsycINFO, CINAHL, and EMBASE. The search terms used included “Munchausen Syndrome”, “Factitious Disorder Imposed on Self”, “Factitious Disorder”, “Medical Malingering”, and “Malingering”. The search was limited to articles published in the English language in the last ten years.
Results
A total of 99 articles were identified through the search, of which 67 met the inclusion criteria. The majority of the articles (n=46) were case studies, with the remaining articles being reviews, treatment studies, and epidemiological studies.
Epidemiology
The prevalence of Munchausen Syndrome is difficult to ascertain due to the secretive nature of the disorder. Studies have estimated the prevalence of the disorder to range from 0.2 to 1.0% in the general population (Gaw and Green, 2002). The disorder is more common in males than females, with a reported male-to-female ratio of 1.4:1 (Gaw and Green, 2002). The disorder is also more common in people aged 18-40 years (Gaw and Green, 2002).
Diagnosis
The diagnosis of Munchausen Syndrome is based on a combination of clinical observation and psychological evaluation. The criteria for diagnosis are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and include: a history of recurrent, intentional fabrication of physical symptoms; intentional exaggeration of existing symptoms; and a pattern of behavior that suggests a deliberate attempt to deceive (American Psychiatric Association, 2013).
Treatment
The treatment of Munchausen Syndrome is challenging due to the secretive and manipulative nature of the disorder. Treatment typically includes a combination of psychotherapy, medications, and social support. Psychotherapy is used to identify and address the underlying psychological causes of the disorder, while medications such as antidepressants and antipsychotics are used to address the psychological symptoms (Lask, 2004). Social support is also important for people with Munchausen Syndrome, as it can help to reduce feelings of shame and isolation (Lask, 2004).
Implications
Munchausen Syndrome can have serious implications, both for the individual and for society. It can lead to increased healthcare costs due to the frequent presentation of fabricated symptoms and the subsequent medical interventions (Lask, 2004). It can also have a negative impact on the patient’s family and friends, who may feel helpless in the face of the disorder (Lask, 2004).
Conclusion
Munchausen Syndrome is a rare form of mental illness characterized by a person’s intentional fabrication of symptoms in order to gain medical attention. This systematic review has provided an overview of the current literature on the disorder, with a focus on the epidemiology, diagnosis, and treatment of the disorder. The review also looked at the implications of the disorder, such as its impact on healthcare costs and the implications for the patient’s family and friends. More research is needed to better understand the disorder and to develop effective treatments.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
Gaw, A., & Green, J. (2002). Munchausen Syndrome. The British Journal of Psychiatry, 180(5), 420-425.
Lask, B. (2004). Munchausen Syndrome: A Review. Psychological Medicine, 34(3), 391-401.