Munchausen syndrome is a mental disorder in which a person feigns or deliberately induces medical symptoms in themselves or in another person. The disorder is named after Baron Karl Friedrich von Münchhausen, who was known for his many fictional stories about his adventures.

Munchausen syndrome is a rare condition. It accounts for 0.2–1.3% of all mental illnesses, and women are affected more often than men. The average age of patients is 34.

Portrait of a person with Munchausen syndrome

Munchausen syndrome is a borderline mental illness, one of the forms of personality and behavioural disorder, in which a person consults a doctor about somatic, imaginary or deliberately induced symptoms and conditions that are not signs of a real pathological condition. This is already a form of deception. However, it is not about obtaining material gain. For these patients, the main goal in life is hospitalisation, and the process of treatment and the stay in hospital matter more to them than the outcome. Bear in mind that such conditions can arise after a genuine somatic illness, the loss of a loved one, or as a result of loneliness.

Such individuals are characterised by disturbed self-esteem and self-control and a strong need for dependency, and in the event of severe disappointment they may retreat into a world of fantasies and daydreams. These patients demand attention from medical staff but try to avoid contact with psychiatrists, because they unconsciously understand the nature of their problem. They therefore prefer to be admitted to hospital late in the evening, at night or on public holidays, when, in their view, young and inexperienced doctors are on duty in the emergency department. They also try to avoid local general practitioners and outpatient clinics, and never go to the same hospital twice. One case has been described in which one such “Baron Munchausen” managed to visit 60 hospitals in a single year.

Interestingly, these patients have a normal or above-average IQ, show no changes in formal thinking, may take an interest in specialist medical literature and can have a thorough understanding of the clinical picture of the feigned disorder. The condition peaks between the ages of 15 and 30, but it can develop in the first few years of life.

The main causes of Munchausen syndrome

Munchausen syndrome is characterised by the fact that people susceptible to it are well aware that they have no pronounced illnesses, yet have a strong desire to be physically ill. At the same time, the psychology of this disorder is not yet reliably understood, although experts agree that the syndrome has its roots in a person’s early childhood. Having once suffered a serious illness and received a share of heightened attention from loved ones, the person wants to experience that maximum care again.

Factors that can increase the risk of developing this disorder include:

  • psychological trauma experienced in early childhood;
  • a predisposition to personality disorder;
  • experience of violence;
  • low self-esteem.

Munchausen syndrome most often affects young and middle-aged women, but it also occurs in men. In more advanced cases, a delegated form of the illness can develop, in which a person with this disorder begins to harm those close to them in an attempt to become ill. In this way they receive attention and the desired degree of sympathy from others.

Munchausen syndrome can be diagnosed at Swiss clinics on the basis of the following criteria

  • The person feigns or deliberately induces medical symptoms in themselves or in another person.
  • The person is aware that their actions are false.
  • The person is pursuing a particular goal, such as gaining attention or sympathy, or avoiding responsibility.

Diagnosing Munchausen syndrome can be difficult, as the person may be very convincing in their simulations. Doctors usually order a series of tests to rule out other possible causes of the symptoms, such as a physical illness or a mental disorder.

Treatment of Munchausen syndrome usually includes psychotherapy. The aim of therapy is to identify and address the underlying problems that lead to the disorder. In some cases, medication may be required.

Switzerland has a number of specialised clinics that CorSwiss works with, such as CALDA and Kusnacht Practice, which diagnose and treat Munchausen syndrome. These clinics offer a wide range of services, including psychotherapy, medication and family support.

Symptoms of Munchausen syndrome

The symptoms of Munchausen syndrome can vary and depend on which symptoms the person is feigning or inducing in themselves or in another person. Common symptoms include:

  • Pain
  • Nausea and vomiting
  • Diarrhoea
  • Difficulty breathing
  • Headaches
  • Fainting
  • Seizures
  • Visual disturbances
  • Hearing disturbances
  • Skin conditions
  • Heart problems
  • Lung problems

In some cases, a person may feign or induce more serious symptoms in themselves or in another person, such as cancer, a stroke or a heart attack.

In addition, people with this condition are known for constant quarrels with medical staff and prevent doctors from speaking to the patient’s family about their condition.

Treatment of Munchausen syndrome

  • Treatment of Munchausen syndrome usually includes psychotherapy. The aim of therapy is to identify and address the underlying problems that lead to the disorder. In some cases, medication may be required.
  • Psychotherapy can help the person understand why they feign or induce medical symptoms in themselves or in another person. The therapist can also help the person develop healthier ways of gaining attention and sympathy.
  • Medication may be used to treat accompanying mental disorders such as depression or anxiety.

Prognosis for Munchausen syndrome

The prognosis for Munchausen syndrome depends on the severity of the disorder and on how motivated the person is to undergo treatment. Overall, the prognosis is favourable if the person receives appropriate treatment.

Munchausen syndrome is a serious mental disorder that can have serious consequences for the person and their family. It is important that people with this disorder receive appropriate treatment.