Karl Fredrich Von Munchausen was an 18th-century German Baron and mercenary cavalryman in the Russian army. When he returned from the Russian-Ottoman war, he started telling stories about his heroism to his friends and neighbors. His stories were so exaggerated that he became famous as a liar when it was eventually revealed that they were lies. For this reason, the name was given to the syndrome that describes those who tell false illness stories.
Many doctors have encountered the phenomenon of factitious disorder in their professional lives. Munchausen Syndrome is the most extreme type of factitious disorder. The triad of feigning illness, pathological lying (pseudologia fantastica) and constant wandering is characteristic. Supporting factors include borderline or antisocial personality disorders, childhood deprivation (or deprivation), diagnostic procedures, lull for treatment or surgery, evidence of self-inflicted physical procedures, information on medical history, being male, multiple hospitalizations. These include a bed history, multiple scars (usually abdominal), police records, and unusual or dramatic presentation. The cases are often men of lower socioeconomic status. It is generally seen in early adult life.
Patients with Munchausen Syndrome may present to physicians in different ways. In a study, it was reported that patients simulating HIV infection or AIDS accounted for 1.7% of all admissions over a period of approximately 5 years. In another study, the prevalence of this disorder among patients admitted due to painful crises of sickle cell anemia was found to be approximately 0.9%. There are even cases in the literature that come in the form of sexual assault.
Common forms of chronic factitious disorders are according to organ systems; It can be classified as abdominal, cardiac, dermatological, genitourinary, hematological, infectious, neurological, psychiatric and self-medication (especially insulin, vitamin, diuretic and laxative) groups.
Munchausen Syndrome was first reported in hospital in 1951. It was used by Asher to indicate a group of patients who wander around and make up illness stories and are willing to undergo unnecessary surgical procedures.
In the condition defined by Asher et al. as "Munchausen Syndrome", the patient frequently goes to the doctor's office or the emergency room with clinical manifestations. It comes with a fabricated story supported by facts. The patient leaves the hospital without getting any results and returns to the hospital again and again, repeating the same situation. These patients are people with psychiatric problems that can deceive even the most astute observers. He may injure his nasopharynx with a sharp instrument, swallow blood, and vomit as if hematemesis. He may skillfully puncture the anal or vaginal mucosa, cause an irregular heartbeat by unnecessarily taking digitalis (heart medication), or appear to have carotenemia by eating large amounts of carrots.
The patient's history is often full of lies. He is seen going to hospitals a surprising number of times and cheating on healthcare professionals. He almost always leaves on his own after violent arguments with doctors and nurses. Numerous scars are characteristic. Lying is a distinctive feature (pseudologia fantastica). They may make up the medical history, give the wrong name during registration. Complaints such as acute abdominal pain, hemorrhagic disorders, rheumatological manifestations, false fever and skin sores are frequently observed.
These patients frequently describe deprivation and childhood traumas in the early stages of life. As a result of this trauma, a person may have unresolved issues with their parents that lead to pseudo-illness. The underlying reasons may be:
*A self-compulsion to punish themselves by making themselves sick
*Feeling important and being the center of attention
Also, patients with extensive medical procedures There is also some evidence to suggest that people who receive prolonged medical care during childhood or adolescence are more likely to develop Munchausen syndrome later in life. This may be because they associate childhood memories with feelings of care. As they get older, they try to gain the same sense of security by pretending to be sick.
Munchausen syndrome can be difficult to treat because most people refuse to accept that they have a problem and will not cooperate with recommended treatment plans. Healthcare professionals should offer a gentle confrontational approach, arguing that the patient has complex health needs and may benefit from referral to a psychiatrist.
One of the greatest ironies about Munchausen syndrome. This means that those who have it are truly mentally ill, but they usually just accept that they have a physical illness. Some experts think Munchausen's syndrome is under-recognized because many people are successful in deceiving medical personnel.
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