Munchausen Syndrome


When The Act series premiered in the USA, it caused a sensation. It tells the story of a woman who was murdered by her disabled and ill daughter in 2015. The series is based on true events that occurred in Springfield, USA. Because of the mysterious nature of the case, Buzzfeed website shed light on the crime in 2016. It presented facts that indicate that the mother suffered from “Munchausen Syndrome” (also known as Factitious Disorder (FD)); a psychological disorder where a healthy person pretends to have a physical or psychological illness and may undergo surgery.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), this disorder is split into: a person faking illness, or a person faking an illness in someone under their care; usually a mother on behalf of her child. Fabricated illness, also known as Munchausen's by proxy (MSBP), was first described by the British pediatrician Roy Meadow, in 1977.

This painful incident was met with rage from people, who suspected the mother to have been derived by financial motives. However, research and studies reject that a sick person would do such an act for the sake of money, stating several other reasons. These include that people with this disorder: a) were abused during their childhood, physically, psychologically, or otherwise; b) lost a family member due to illness, travel, or fluctuations in personality and depression; c) have weak personalities and identities, and lack self-respect; d) remember the amount of attention and care they received when they got ill as children; or e) desire to be with healthcare providers, such as doctors or nurses, or in medical places, such as hospitals and clinics.

Munchausen syndrome is more common in men than in women; infected people tend to be women aged 20–40 years and men between 30–50 years old. In fact, it is difficult to detect people with this syndrome because they possess some medical terms and have a superior ability to deceive and manipulate, as evidenced by their bodies with multiple scars from previous surgeries. Similarly, MSBP cases are difficult to detect because the parent may change the doctor whenever s/he has doubts.

"Epidemiology of Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation" is a study submitted to the British Pediatric Surveillance Unit and was carried out between 1992–1994 in England and Ireland. A total of 128 cases were identified: in 85% of occasions the perpetrator was the child's mother, most cases were children under the age of 5 years, and 68 children suffered severe illness of whom 8 died.

For its nature as a mysterious disorder or difficult to diagnose, there is an ongoing debate among doctors in general—especially that the complications may amount to death, organs or limbs loss, or infection with diseases such as diabetes—about the best way to diagnose and understand this syndrome. However, the DSM has set several standards for doctors, such as noticing that the patient: deliberately pretends to suffer from physical or mental problems, constantly complains of illness or pain without medical evidence, has extensive knowledge of medical matters, and has several surgical scars on his/her body although his/her examinations or medical history do not show any physical problems.

According to several studies, there are no effective drugs to treat this disorder. Yet, when the patient admits his/her problem or the doctor discovers the syndrome, psychoanalysis, cognitive-behavioral therapy (CBT), and long-term psychotherapy can help. If the patient does not respond to behavioral therapy, the therapist may opt for medications for associated mental health conditions, such as depression or anxiety. However, one of the successful solutions for treating MSBP is to separate the parent from the child for a long time.



Photo: Freepik

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