Munchausen's syndrome psychological factors preventing recovery. Munchausen syndrome: causes, diagnosis, treatment

For the first time, the name of such a disease was used by Dr. Asher Richard, who established its presence in his patients in 1951. With Munchausen's syndrome people constantly visit medical institutions unnecessarily, mislead their loved ones, medical staff of clinics. This condition is caused by severe emotional disturbances. As a rule, patients with such a diagnosis have good knowledge in the field of medicine.

Also some of them have the psychological skills of persuasion, thanks to which it is easy to convince doctors to conduct a serious examination, complex treatment non-existent disease. Deception in this case is conscious, and motivation is subconscious. Often such a syndrome manifests itself in parents who impose imaginary diseases on their children, subject them to diagnostics, deliberately causing harm to health and life. At the heart of such psychological disorder lies the human need for attention, care, as well as a close relationship with their children and loved ones.

Causes

The causes of Munchausen's syndrome may overlap, they can only be established by a professional psychologist, psychoanalyst, neurologist.

The main causes of the syndrome are:

• an acute need for attention, understanding, care that a person cannot quench by other methods;
• childhood spent in an incomplete family, in which one of the parents was not able to fully spend time with the child due to increased employment or unwillingness to take part in the educational process;
• youth that passed in an atmosphere of emotional insecurity;
• serious illnesses suffered in childhood;
• problems with self-esteem;
• egocentrism;
• sexual abuse in the past;
• the presence of relatives who have suffered serious illnesses in the past;
• psychological immaturity;
• lack of self-esteem;
• experienced stress;
• unfulfilled dream of becoming a medical worker;
• serious personality disorders.

In addition, a person with this syndrome is much more comfortable to be in a medical facility than in his own home among loved ones. This is where he feels safe.

Symptoms

The symptoms of Munchausen's syndrome are very diverse. This and simulation of somatic or mental illness , coupled with an obsessive desire to be tested, risky surgical interventions, and constant complaints of poor health and weakness and, as a result, the need to constantly be under the supervision of doctors in a hospital.

Most patients have serious problems in communication, especially with loved ones, feel the need to communicate exclusively with healthcare workers. For them, they arrange whole dramatic performances that tell about incurable diseases and the suffering experienced by such an imaginary patient.

Patients with Munchausen's syndrome are often unmotivated aggressive, their mood constantly fluctuates from depressive-suicidal to a state of complete apathy.

They often suffer from profuse bleeding caused by the use of a large number medicines or chemical substances used arbitrarily.

Often people who do not find support from their loved ones leave home, begin to wander, up to complete asocialization.

The main diseases that simulate patients with the syndrome:

• migraine;
• skin diseases;
• problems of the cardiovascular system;
• proctological or gastroenterological problems;
• diseases of the respiratory system;
• severe diseases (tumors), etc.

Classification

The main types of this disorder:

• Individual Munchausen syndrome, as a result of which the patient invents a disease in himself and requires increased attention to his person.
• Delegated syndrome, in which parents force their children to feign or deliberately cause certain disorders in children.

Diagnostics

It is not always possible to determine the presence of Munchausen's syndrome in a person after the first examination. Often such patients, feeling suspicious on the part of the doctor, abruptly leave the medical facility and turn to another specialist. Without finding support at home, the patient may go missing. Diagnosis of the syndrome should be carried out delicately, with the direct participation of a professional. The patient must be examined by a neurologist. You will also need to consult a psychotherapist, and the patient's relatives should also participate in it.

Treatment

Therapy in this case is not easy. effective ways for complete cure Unfortunately, the patient does not exist. But there are a number of recommendations that should be followed.

For the treatment of the syndrome, regular consultations with a psychotherapist, as well as family consultations with a psychologist and participation in psychological trainings. The attending physician will certainly prescribe medication to correct concomitant mental disorders. If necessary, temporary hospitalization in a psychiatric hospital will be offered.

Sometimes experts use the so-called " non-confrontational approach”, in which the patient is actually “treated” for a non-existent disease (if the treatment does not involve medication). Massage, physiotherapy, etc. may be used.

• communicate with people more often;
• find a new activity or hobby to distract from disturbing thoughts;
• lead healthy lifestyle life, minimize health risks;
• travel;
• engage in social, volunteer activities.

Prevention

Unfortunately, effective preventive measures with this disease does not exist. Patients who are deprived of attention from loved ones, lonely people, especially the older age category, are recommended to communicate with people more often, to get a pet that can brighten up loneliness.

Forecast

At first glance, it may seem that Munchausen's syndrome is not serious, since it does not affect a specific organ or system. In fact, people who have a great need for the attention and care of relatives risk not only their health, but also their lives. Often in this category of patients comorbid psychiatric disorders develop: obsessions depression, loss of interest in life. As a result A person suffering from Munchausen's syndrome has the following complications:

• problems in communicating with people;
• job loss;
• financial difficulties;
• loss of working capacity as a result of injuries;
• diseases of the organs, up to disability, due to the intake of heavy toxins and a large number of drugs for other purposes;
• alcohol and drug addiction;
• getting into an unfavorable social environment;
• fatal outcome.

Parents who deliberately harm the health of their children are prosecuted, deprived of parental rights, and sent to psychiatric treatment.

An experienced psychotherapist should provide comprehensive assistance with such a disease. You may need to consult a neurologist, psychologist, family doctor, who together will make an accurate diagnosis, recommend treatment and regularly monitor the person's condition.

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Which are prone to imagination and fantasies. But these are not just fantasies on innocuous topics! The fact is that such people experience a simulation disorder. They deliberately like to cause any painful syndromes and symptoms in themselves, so that they are hospitalized with further long-term treatment and even surgical intervention! They just want to be in hospital beds! We'll talk about this.

Who is this Munchausen?

Munchausen's syndrome got its terminological name on behalf of the real historical prototype - the German baron Karl Friedrich Hieronymus Munchausen, who lived in the 18th century in Germany. He was a cavalry officer and gained wide popularity while serving in the Russian army and participating in the Turkish wars.

After retiring, Baron Munchausen became famous as a man who constantly composes the most incredible and fantastic stories about his military adventures and adventures. Subsequently, this formed the basis of a book about the adventures of Baron Munchausen, written by his contemporary Rudolf Erich Raspe.

Munchausen syndrome. Symptoms

This syndrome is considered to be a very rare disorder. Patients suffering from it do not fall into psychiatric hospitals, but in the most ordinary hospitals and surgical departments. It's hard to believe, but they just want to get there. So we come close to the symptoms of this strange mental disorder. This is:

• constant complaints of pseudo-diseases;
• permanent surgical interventions and frank operations;
• almost eternal stay in hospitals.

Today, this is considered an extreme form of feigned human behavior that is central to their lives.

Munchausen syndrome as a pathological deceit

In addition to the above-described attraction to everything medical, patients suffering from this form of disorder are prone to pseudology, i.e. to pathological deceit. While in the hospital, they come up with more and more new symptoms, supplementing their complaints ... Often they stage various attacks of various diseases, and all in order to be hospitalized as soon as possible. Madhouse.

Types of Munchausen Syndrome

Munchausen's syndrome has several types. It all depends on the favorite symptoms attributed to themselves by patients.

And finally

And one more thing: a common feature of all "Munchausen" is that they simply love to "manage" their own treatment while in the hospital. They consider themselves sufficiently enlightened in the field of medicine, since they independently "draw" certain clinical pictures showing the right symptoms at the right time.

The merry adventures of Baron Munchausen not only entertained the listeners, for some they became a way of existence. Such home-grown "Munchausens" were so involved in this role that they even began to mislead doctors, appearing to be extremely sick, requiring not only treatment, but also care, increased attention and care.

It is unlikely that an uninitiated person knows what Munchausen's syndrome is. But psychiatrists are well acquainted with him. People in this state, the origin of which is not yet fully understood, actively and very plausibly portray (simulate) the disease. At the same time, they are able to simulate fainting, seizures, vomiting, and due to the fact that such a condition is “contrived” and caused artificially, in psychiatry it is called the Munchausen syndrome. Presumably, it may be the result of problems rooted in childhood. It can be:

• suffered in childhood, including sexual abuse;
• lack of parental attention and love;
• the suffering of a seriously ill relative;
• loss loved one;
• low self-esteem;
• a number of mental disorders that accompany Munchausen's syndrome, including those caused by work in the healthcare system or, conversely, an unfulfilled dream of becoming a doctor.

Munchausen syndrome - symptoms of adults

Simulation of diseases in adults, according to experts in the field of psychiatry, originates in childhood, and if the history of childhood simulations is quite understandable and, at times, even amusing, then Munchausen syndrome, the symptoms of which appear in mature people, indicate serious problems mentality of an imaginary patient. At the same time, they are imitated very skillfully and are capable of misleading a medical worker.

In such a pseudo-patient, the following can be detected: heart attack, diarrhea, various fevers with “blurred” symptoms. There are also more severe cases of diseases or medical problems which are organized by the Munchausens themselves, distracting doctors from real patients and making it difficult to make a true diagnosis. Among them are those who are able to deliberately injure themselves and even engage in self-harm.

How to treat Munchausen's syndrome?

Experts say that patients who have Munchausen's syndrome are diagnosed, the treatment offered by the doctor, as a rule, is rejected. They demand increased attention to themselves, try to dictate their terms of therapy to the doctor and, if he does not agree, they go to another doctor, rejecting, among other things, psychiatric care. If they do not receive the care and treatment they want, as they imagine it, people with this diagnosis become extremely aggressive, suspicious and intractable. Their treatment rarely brings positive results.

Imaginary patients are sometimes confused with hypochondriacs, although there is a difference between them. If hypochondria is usually the result of serious illnesses suffered in childhood, which in adulthood cause constant fear and anxiety for the state of one's health, then Munchausen's syndrome is considered differently. Such people know perfectly well that they are not sick, but they try to assure others that they have ailments, even by deliberately harming their health.

Their contribution to the appearance of the disease is often made by allegedly compassionate parents, who form the so-called delegated Munchausen syndrome, deliberately forcing the baby to simulate the disease in order to attract the increased attention of doctors to him. Such constant false concern for the child's health can lead to the development of a sense of inferiority in him, in terms of physical development, refusal to play with peers and other serious consequences.

Movies about Munchausen syndrome

This amazing state of a completely healthy "sick" is of interest not only to psychiatrists, but also to filmmakers. It is no coincidence that Munchausen's syndrome has found its place in the cinema. Among the films in which you can meet the characters who own it:

1. The famous series "Doctor House", in episode 9 of which viewers see how a patient with this syndrome is treated.
2. TV series "Bridge" (Sweden-Denmark), where a character with this disease appears in episode 2.
3. Grey's Anatomy series(4 series).
4. TV series "True Detective"- a character with a delegated view syndrome.
5. Film One Missed Call (Japan) where is the mother main character suffers from this disease.

Munchausen syndrome - common name mental state patients who come to doctors with trumped-up symptoms of various serious illnesses and insist on hospitalization (long-term treatment, even operations). In fact, these are invented reasons that the patient skillfully simulates. They are caused by the acute desire of a person to be surrounded by care, attention, respect for oneself.

If in most cases the names of diseases and symptoms are associated with the name of the researchers or doctors who first described the case of this disease, then everything is completely different here. The syndrome was first described by Dr. Richard Asher in 1951. He also insisted on naming the syndrome after the great inventor Baron Munchausen, the protagonist of the book by Rudolf Rapfe. He is well known even to children for his pathological lies and fictional stories about the exploits he allegedly performed (pulled himself out of the swamp by the hair, etc.). The prominence of the hero of the book makes the symptom more recognizable to doctors when making a diagnosis.

Causes of the syndrome, signs

If ordinary simulators aim to obtain a sick leave, certificate, etc., then in the case of Munchausen's syndrome, the main goal of the patient is to impersonate a terminally ill person as plausibly as possible, skillfully simulating various symptoms. For them, this is a kind of game, the purpose of which is to outwit the doctors. Most often, patients with this syndrome are well educated and know how to “paint a picture of the disease” correctly. Sometimes they deliberately injure themselves, take drugs that cause the symptoms of the disease necessary for plausibility, swallow objects, and so on.

Simulation of the disease becomes the main goal of the patient. After all, only in this case he will receive his “portion” of attention, sympathy and understanding from the side. medical staff, roommates, colleagues and relatives. In this way, he compensates for the lack of attention, which is lacking in a measured everyday life.

Patients with Munchausen syndrome are so cunning and dodgy that they find many ways to get the maximum portion of attention. They know exactly when and which doctor to contact, at what time it is better to call an ambulance (the end of the appointment or a day off) and try not to inform him of their medical history so that the deception does not accidentally come to light.

If the doctor Munchausen turned to reveals a lie, he is immediately declared incompetent, they complain to all authorities and find another specialist. Slander and slander by doctors is a common thing for such patients. At the same time, as soon as they see support, they immediately “stick” to a new victim, sing praises to her, and as soon as they are caught in a lie, the attitude immediately changes and the friend turns into another enemy.

They always go to the examination of complaints and actively participate in all necessary procedures, reveling in their significance and skillfully "juggling medical terms", putting their knowledge in this area above the "half-educated doctor".

Symptoms of pathology

Doctors who, by virtue of their profession, have direct contact with the Munchausen patient, note that the syndrome itself is a middle state between simulation and a borderline state. "Barons and Baronesses" - patients of psychologists and psychotherapists. But direct contact and subsequent treatment are most often refused, provoking conflicts and making excessive demands on others.

In most cases, they skillfully simulate diseases that can be provoked by taking certain medications (in extreme cases, they injure themselves):

• Heart attack;
• migraine;
• diseases of the gastrointestinal tract (ulcer, gastritis, diarrhea, etc.);
• asthma, tuberculosis;
• surgical diseases (appendicitis, adhesions, polyposis, etc.);
• tumors (including the brain).

All Munchausen patients have common features character and behavior by which they are quite easy to recognize by general practitioners:

• Artistic and persuasive;
• have a rich imagination, fantasy;
• hysterical when they are refused;
• egocentric (up to megalomania);
• infantile;
• narcissistic;
• have a good education and high level intellect;
• obsessed with the idea of ​​getting well;
• incapable of social adaptation(single and not inclined to career growth);
• false;
• have deep knowledge in the field of medicine and psychology;
• lonely and feel like nobody needs them.

They carefully prepare for each visit to the clinic, think through all possible dialogues. Most often, they do not waste time going to the clinic - they immediately call the ambulance service, because "they are dying, and they need to come immediately." As a rule, the call is planned on a weekend or at night, hoping for the arrival of inexperienced doctors who will not be able to quickly understand the situation. If they go to the clinic, they consciously choose the time at the end of the working day or on the day before the day off, when the doctor is already tired and will “be led” to the persuasions of the simulator.

They do not report their “heroic deeds” of going to the doctors, as well as the results of previous studies, so that it would be impossible to trace the dynamics of the “pseudo-disease” and directly convict of lies.

Favorite way - contacting specialists the highest category, "luminaries of science", because their disease is complex and difficult to diagnose by conventional doctors. If the desired diagnosis is not confirmed, they bombard the higher management with complaints and accuse the “luminaries” of incompetence, “bought a diploma”, etc.

Data by which an adult "baron" can be recognized:

• Frequent hospitalizations and examinations;
• sharp exacerbations of the disease that are not confirmed by analyzes and survey data;
• colorful stories about illnesses and endured suffering;
• an acute desire to get help (up to surgery);
• abundance of symptoms different nature unrelated (cramps in the calves and asthma, for example);
• constant requests for medication, most often analgesics;
• good knowledge medical terms and medicines;
• instructions to doctors about the wrong dosage of drugs, prescriptions, drawing them into disputes.

Classification of Munchausen's syndrome

Psychiatrists easily recognize Munchausen's syndrome by the patient's endless complaints about poor health, constantly pursuing pain, and demands for immediate surgery.

The syndrome is divided into 2 types:

1. Individual;
2. delegated.

Individual has several main subspecies, which are classified depending on the type clinical manifestations and "symptoms":

• Abdominal (thrust for abdominal operations and surgical intervention);
• hemorrhagic;
• neurological;
• dermatological;
• swallowing;
• albatross;
• pulmonary-bronchial.

In addition to those listed, other less common subspecies are possible.

Delegated Munchausen's syndrome is the most dangerous because it is typical for women with psychological disorders.

Delegated Munchausen Syndrome

In medical sources, this syndrome has several different names: "Munchausen syndrome by proxy", "Third person syndrome", "Proxy syndrome". In most cases, it occurs in women.

The object of close attention of the "baroness" are their own children early age(usually under the age of 4 years), who cannot object or resist them. It is sometimes quite difficult to identify the mother - the "Baroness", but it is necessary, since children receive psychological trauma or endure physical suffering that is deliberately inflicted on them. The danger lies in the fact that adolescence the child may fall into depression, will not be able to normally build relationships with peers, and in the future to build a family.

Such mothers can initially be classified as “hyper-custody”: they diligently expose their concern for the health of the baby for show: they actively consult on any occasion with doctors, neighbors, friends and on forums in special groups dedicated to raising and caring for children. But at the same time, their opinion is always the only true one, and any objection causes a reciprocal fit of anger.

From the outside it looks like the experiences of a caring mother, but in fact the child is harmed. She most often suffers herself from a lack of attention, a problematic marriage, or from childhood trauma (psychological or physical abuse, suppression of the personality, despotism of teachers or parents).

The "Baroness" really gets her "portion of happiness" when she is praised for the timely visit to the doctor or the kindness that she also shows to other children. Nurses or nannies kindergarten Those who have this syndrome are sensitive to praise from patients and parents, but they are not concerned about the result obtained, but about attention to their own person.

But one has only to blame a patient with Munchausen syndrome for something or express his suspicions to him, as he immediately begins to attract a new portion of attention to his person: he begins to deliberately expose himself as a victim of slander, gossip, slander. A new round of "rays of glory" will give an incentive to new "feats". An inventive mind helps to be persuasive.

Typical symptoms in a child

Victims of mothers - "Baroness" are easily recognized by experienced pediatricians and are often noted by teachers who listen to complaints about the "fatal disease of their beloved child."

These signs are characteristic of the victims of patients with Munchausen's syndrome:

• Examinations (laboratory, hardware) indicate the absence of the disease;
• however, complaints of illness continue;
• the mother is indignant, requires further examination;
• initially diagnosed rare disease(“for the first time in my practice, a rare case” - the phrases of an experienced pediatrician);
• parents are masters of medical terminology;
• the mother is inseparably near the child, is responsible for him on the questions posed;
• when communicating with a child without parents, the symptoms "disappear";
• treatment does not work.

The problem of diagnosing delegated Munchausen syndrome is complicated by the fact that it is difficult to prove intentional harm to a child. Indeed, for society, a sincerely caring mother or guardian is less suspicious than those parents who pay less attention to their child, raise them independently, and go to the doctor only when it is really necessary.

Diagnosis and treatment

Diagnosis of Munchausen's syndrome is always difficult and time consuming. A psychologist or psychotherapist can make a diagnosis only in case of long-term observation. The constant lies and peculiar behavior of the patient is a kind of game for him, into which he also draws the doctor. These are difficult patients who cannot be treated by coercive methods - for referral to compulsory treatment no legal basis.

It is possible to correct the behavior only in the case when the patient was "caught in a hot" or he voluntarily came to see a psychologist when he realized that he "finally lied". The percentage of such patients is extremely low.

Treating the "barons" is a complex task that requires a lot of time and patience on both sides. H There is no single technique that will help correct his behavior. However, some general recommendations for such patients, you can still use:

• Establish contact and trusting relationship with one doctor;
• increase the circle of new friends, acquaintances, friends;
• find a new hobby and like-minded people;
• live a healthy life;
• start leading an active social life (volunteering, social service);
• get a pet that will require a lot of attention.

Lack of attention is the problem of our time, but we can cope with it. Drawing attention to yourself is not difficult, especially if you play "fair" and do not manipulate at every opportunity.

Munchausen syndrome is an intriguing name for a very rare borderline psychiatric disorder. The essence of this disease is an obsessive desire to be treated. From everything and wherever possible. The main goal of people with Munchausen's syndrome is to achieve hospitalization in a medical institution by any means. To do this, they resort to the most various activities: injure themselves, swallow foreign objects(spoons, hairpins, and so on), accept medications and, of course, lying to doctors. At the same time, the simulation does not have any delayed goal (for example, shirking from work or obtaining a certain medical opinion). Patients with Munchausen's syndrome do all this simply for the sake of the fact of treatment. What kind of disease is this, why it occurs, how it can manifest itself and how to deal with it, we will try to figure it out in this article.

A bit of history

Munchausen's syndrome was first described by Dr. Richard Asher in 1951 in a patient obsessed with healing. The name was given in honor of the great visionary German Baron Munchausen, who became a hero of literature, thanks to his phenomenal ability to invent. This is what distinguishes all patients with this syndrome. In their irrepressible desire to be treated, they resort to such sophisticated tricks that are not always recognized by the medical staff. As a result, patients with Munchausen's syndrome find themselves in a hospital bed, having achieved what they want, and sometimes on the operating (!) Table. AT medical practice a case of Munchausen's syndrome is described, when the patient got on the operating table 40 times, without needing at all surgical intervention(so skillfully she simulated the necessary symptoms for this).

Causes

Patients with Munchausen syndrome often study medical literature thus forming a medical history.

To date, Munchausen's syndrome is one of the manifestations of hysteria. It is believed that the source of this condition are numerous psychological problems childhood. Most often, Munchausen's syndrome occurs in people who were not loved enough in childhood by their parents, grew up in an incomplete family, and had an attention deficit. If you delve into the past of such patients, you often find the fact of some disease, after which the relatives paid more attention to the child than usual. And then in my head small child a stereotype was formed: in order to be loved more, you need to get sick. And this stereotype carries over into adulthood.

People with Munchausen's syndrome are prone to certain traits character, such as selfishness, egocentrism, a tendency to demonstrativeness. They are characterized by a high level of anxiety, overestimated or underestimated self-esteem, they are often socially maladjusted and, as adults, cannot create their own family in any way. The syndrome is more common in females. Men with this syndrome are prone to aggressive behavior.

Another feature characteristic of patients with Munchausen's syndrome is their rather high intellectual level. These people, before seeking medical help, study the medical literature, carefully forming their medical history. They think through everything to the smallest detail so as not to be caught off guard and not to be recognized in their lies. It can even be healthcare workers who have easy access to medicinal substances and corresponding professional education. This is partly why such patients manage to deceive even competent doctors with experience. When exposed, patients with Munchausen's syndrome always behave extremely emotionally, categorically deny the "fictitiousness" of their symptoms, and even threaten the doctor. Not getting what they want in one place, they are sent to another medical institution. And so history repeats itself many times.

Symptoms

Patients are able to portray fainting in such a way that even experienced specialists cannot reveal the deception.

Pathological manifestation Munchausen's syndrome is the assignment of a disease to oneself. That is, in fact, there is no disease, and this is well known to a patient with Munchausen's syndrome. But by all means, he must convince the medical staff and others of the presence of the disease. For this, all acting skills will be used. Describe everything possible symptoms Munchausen's syndrome is simply impossible, because they can be any, as long as the patient's imagination and sophistication of the mind is enough.

And yet, it is possible to list the most common "diseases" with which the "Munchausens" end up in a medical institution. These are the situations:

• bleeding from various places. Patients injure their gums in order to truly portray hemoptysis, damage the anus and the tissues around it, so that one can talk about intestinal bleeding. Sometimes paint or animal blood can be used for these purposes. And some patients specifically take drugs that help reduce blood clotting, thereby provoking the development of bleeding;
• and . This is perhaps one of the most favorite acting performances of patients with Munchausen's syndrome. And fainting, and all sorts of epileptic seizures portrayed so believably that they are almost never recognized as fake. In severe cases, it comes to the point that patients provoke the occurrence of a true fainting or convulsive seizure by taking medicines, because then the mosquito will definitely not undermine the nose, and no one will doubt the authenticity of the disease;
• acute abdomen and other abdominal problems. Cause nausea and vomiting? No problem! Fake abdominal pain? It's as simple as that! Or, for example, you can artificially induce diarrhea (the arsenal of laxatives in the pharmacy is quite wide). And even better - all at once, because then they will probably be left in the hospital! This is exactly what patients with Munchausen's syndrome achieve;
• . There is already a place where you can roam sick fantasies. What kind of damage the patients themselves do not inflict! Moreover, most often the injuries and wounds themselves turn out to be insignificant and not at all dangerous, but at the same time profuse bleeding(for this, someone else's blood or paint is used) and a strongly pronounced pain syndrome with the corresponding emotional coloring. In some cases, patients may self-amputate a finger or even a limb;
• skin diseases. To simulate dermatological problems, patients with Munchausen's syndrome smear themselves with ointments and creams, slash with nettles, expose themselves to insect bites, infect minor skin wounds, and so on;
• an increase in body temperature of unknown origin. To do this, patients inject themselves with a syringe of lyophilizates of bacteria.

A characteristic feature of "Munchausen" is the diversity of symptoms, that is, their number can grow in geometric progression(especially if the patient feels doubts on the part of the doctor about the truth of the disease). Such patients want to be privy to all the details of their condition, the intricacies of the examination, and sometimes even come to the doctor with advice on how to treat them. If the deception is not revealed, then the patient with Munchausen's syndrome increases self-esteem. After all, he was able to deceive the doctor! And the more titled the doctor, the more unique and talented the patient feels. Other patients prefer younger, inexperienced doctors who work weekends or nights because they feel they are more likely to be fooled.

If it is not possible to deceive the doctors, then after a categorical denial of his simulation, statements about the incompetence of the corresponding attending physician, the patient with Munchausen's syndrome retires. However, after some time, he appears in another medical institution with a new scenario. And this can go on for a lifetime. Endless circles of walking around hospitals. . . It is interesting that abroad such patients who constantly seek medical help for various reasons are entered into a computer database, access to which is available to anyone. medical institution. If the doctor has any doubts about the veracity of the symptoms, then sometimes this database allows you to expose the patient. But in cases where urgent health care and there is no time to look into this database, this method of registering patients does not work.

Delegated Munchausen Syndrome

Such persons can harm the health of their loved ones, recreating a picture of the disease in them.

There is a separate type of Munchausen's syndrome, which is called delegated. This is the most dangerous situation, because in this case the picture of the disease is recreated not in the patient himself, but in his ward (a close relative with a disability or a child). In such cases, "Munchausens" harm the health of a loved one, which can end very tragically. Babies may not be fed or fed tainted food, given unnecessary medications or wrong doses, and may even obstruct breathing by covering their head with a pillow or blocking their nostrils with their fingers. It is not always possible to “catch a hot” patient, which aggravates the situation.

Deliberate actions are performed in order to subsequently care for a now sick child or relative, thus attracting more attention, and sometimes praise for fortitude and selflessness. Mostly delegated Munchausen syndrome develops in single women with depressive episodes. Suspecting delegated Munchausen syndrome is often even more difficult than usual. After all, not everyone will dare to announce publicly about such deliberate actions, and even in the absence of evidence, having only speculation. And the "Munchausen" in such cases will set others around against the one who expressed such absurd, it would seem, suspicions. And it is still unknown whose arguments will be more convincing.

Diagnosis and treatment

Diagnosis of Munchausen's syndrome is quite difficult, since there is no algorithm for the doctor's actions in such cases. Suspicion should arise when additional (objective, so to speak) research methods do not show any changes on the part of the body. That is, no pathology is detected, and which of the complaints grows and grows. But, unfortunately, this is not always possible. After all, a patient with Munchausen's syndrome may have real health problems that he exaggerates. Or he can use drugs that will change the indicators during the examination, because the "Munchausens" are quite professional in preparing their "disease".

Treatment of Munchausen's syndrome is no less difficult than diagnosis. The situation is due to the lack of criticism of their condition in such patients, and hence the understanding of the need for treatment. "Munchausens" do not recognize their illness, therefore, in most cases, if the disease can be diagnosed, treatment comes down to limiting medical interventions(especially surgical), termination of inpatient treatment. If a psychiatrist or psychotherapist can find the key to the patient, rational psychotherapy is possible. However, it is rarely effective. Most often, after a while, patients with Munchausen's syndrome are taken for their own: they again begin to wander around medical institutions with the latest inventions.

In some cases, the appointment of either antipsychotics (depending on the psychological background of the disease) alleviates the patient's condition. But since it is impossible to force such patients to take medicines, most often these attempts to get rid of the disease are unsuccessful.

Another approach to the treatment of such patients is the appointment of a placebo, that is, dummy pills. After all, patients are looking for treatment, in which case they find it and calm down for a while. Not all doctors consider this approach justified, because it is an indulgence of the disease, but sometimes this method allows you to stop a series of adventures with doctors.

In general, we can say that Munchausen's syndrome has not yet been treated. Doesn't exist yet effective methods treatment with appropriate evidence base. The only thing that pleases is that patients with Munchausen's syndrome are not so common. But let's hope that the development of science will make it possible to find control over this disease in the future.

Thus, Munchausen's syndrome is a rare psychiatric problem when a patient invents or embellishes the symptoms of a disease, trying to convince others that he has it. The disease is difficult to suspect and diagnose, and even more difficult to deal with it. Getting rid of Munchausen's syndrome is the task of the future.

Radio channel “Moscow Speaks”, program “Together with a Psychologist” on the topic “Lie or Munchausen Syndrome?”:

Channel 24, the program "Health Facts" on the topic "Munchausen Syndrome" (Ukrainian):