Scholarly Review of the Munchausen Syndrome Report

Introduction

There are not many conditions as unsubstantiated as the Munchausen syndrome. It is a factitious disease in which the affected pretends to be sick or deliberately takes action to produce some symptoms of illness in themselves (Baig, Levin, Lichtenthal, Boland, & Breitbart, 2016). The disorder carries the name of a German aristocrat, Baron Munchausen, who was famous for spreading outlandish, unbelievable stories about his life (Padhye, David, Dholakia, Mathew, & Murugan, 2016). With no physical basis, the condition is classified as psychological and is hypothesized to originate from heightened emotional responsiveness and, possibly, past trauma. This paper aims to review the recent scholarly publications regarding the Munchausen syndrome to identify the patterns and possible causes of the condition.

Review

Academic literature presents little evidence of the disorder, often due to low participation rates from the patients or their sudden disappearances immediately after the diagnosis. Because of that, most existing records of the syndrome come in the form of case studies which examined the condition only upon the encounter rather than building a hypothesis beforehand. Therefore, the authors of the scholarly articles presented in this paper did not choose their populations or formulated their hypotheses prior to beginning their work, instead documenting it post-factum.

For instance, in 2016, Padhye et al. evaluated the story of a 44-year-old woman who reportedly visited her local hospital with complaints about pain in her lower back for 11 consecutive years. The patient tried to connect the “weakness in both lower limbs” and the above concerns with a car accident she had in 2002 (Padhye et al., 2016, p. 152). She reported being hospitalized and undergoing a surgical procedure shortly after the event, recalling a “near-complete relief of all her symptoms in the days following the surgery” (Padhye et al., 2016, p. 153). A similar sequence of medical interventions repeatedly occurred later, in 2006, 2010, and 2013, none of which carried imaging studies of her condition, which complicated her case. Case authors used medical testing as a method to evaluate the patient’s condition. After examination by the researchers, no pathologies or abnormalities with her bone structure were found to explain her symptoms.

However, the academics discovered that the woman grieved the loss of her mother. She also had “an unfulfilled psychological need to be cared for by the family and the society at large” and refused further psychiatric treatment when presented with the hypothesis (Padhye et al., 2016, p. 154). The pattern of multiple surgical procedures, “often followed by dramatic improvement and then relapse, should trigger a suspicion of Munchausen syndrome,” the researchers concluded (Padhye et al., 2016, p. 155). They further emphasized the importance of case documentation to avoid unnecessary surgeries like those in the case.

Another form of the disease is called the Munchausen syndrome by proxy and manifests itself when a third-party report the symptoms of physical illness on behalf of someone else, usually a parent on behalf of a child. A series of cases of this condition have been documented by Sarhat (2016) in Iraq, where ten children less than seven years of age have been hospitalized with a “multisystem disorder” (p. 276). All victims were referred to the Al-Tifil hospital by their mothers or aunts, who were believed to have extracted relationship or economic benefits from the procedures. As “women’s relations outside marriage are absolutely unacceptable” in the Iraqi culture, the women perpetrators were possibly motivated by social contact with females outside their family circle. Although most victims did not suffer from adverse consequences, one child died due to malnutrition and intermittent medical care. After using the method of survey research to evaluate the cases, the researchers concluded that “urgent guidelines” are needed to “create awareness…in the medical community…even in the parents’ behavior appears normal” (Sarhat, 2016, p. 271). This study revealed how cultural norms can lead to negative consequences.

Patel and Daniels (2018) reported a case of a 19-year-old female raised in foster care who was repeatedly hospitalized for factitious hypoglycemia (low blood sugar and associated feelings of weakness). Over three weeks, the woman visited the emergency department more than three times. After being medicated with dextrose and other drugs to stabilize her sugar levels during these episodes, the female was tested for drug usage, factitious insulin usage, and neurological causes. The researchers used medical testing as a method to evaluate her condition. All the tests reported negative for any signs of preexisting or forming conditions, leaving the doctors to conclude that the episodes have been fabricated. Further interview revealed that the patient has been injecting insulin to provoke hospitalization and the real cause of this behavior lay in her complicated social situation. The 19-year-old was an undocumented immigrant that recently left her foster parents and lived in a stressful environment of a “halfway house” (Patel & Daniels, 2018, p. 3). The researchers proposed that “at-risk adolescents should be screened for psychosocial causes” and concluded that the syndrome should receive more attention to prevent unnecessary testing (Patel & Daniels, 2018, p. 5).

Conclusion

Thus, although the disorder is difficult to document, many instances have been recorded to raise awareness of its existence. Due to its psychological nature, the condition can hardly be studied in a laboratory or field environment, leaving individual or series of case studies as evidence. The above analysis of contemporary academic literature revealed both conscious and subconscious instances of the Munchausen syndrome and introduced the phenomenon of a Munchausen syndrome by proxy. Because evident psychological triggers and symptoms have not yet been identified, more awareness should be raised about the condition to avoid unnecessary hospitalization or possible adverse reactions.

References

1. Baig, M. R., Levin, T. T., Lichtenthal, W. G., Boland, P. J., & Breitbart, W. S. (2016). Factitious disorder (Munchausen’s syndrome) in oncology: Case report and literature review. Psycho-Oncology, 25(6), 707–711.
2. Padhye, K. P., David, K. S., Dholakia, S. Y., Mathew, V., & Murugan, Y. (2016). “Munchausen syndrome”: A forgotten diagnosis in the spine. European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 152–156.
3. Patel, A., & Daniels, G. (2018). Hypoglycemia secondary to factitious hyperinsulinism in a foster care adolescent – A case report of Munchausen Syndrome in a community hospital emergency department setting. BMC Emergency Medicine, 18(1), 1-6.
4. Sarhat, A. R. (2016). Munchausen’s syndrome by proxy in Iraq; Case series. Tikrit Medical Journal, 21(1), 271–284.