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 DEFINITION
The Münchhausen syndrome consists of a repeated simulation of physical, usually sharp, pompous and convincing illnesses, for a person who strolls around from one hospital to other in search of treatment.
CHARACTERISTICS
These patients are capable of simulating many such physical illnesses like infarction of myocardium or fever of unknown origin. Sometimes they end up by turning into an interminable responsibility for the medical or surgical services, but, nevertheless, the fundamental problem is the psychiatric one, much more complex than a simple deceitful symptoms simulation, and linked to serious emotional disorders. The patients can have histrionic personality features, simultaneously that are intelligent and with resources. They know how to simulate an illness with sophisticated skill. S and they differ from the pretenders in which his lies and simulations are conscious, but the motivations to feign the illness are to a great extent unconscious. The fault feelings are clear.
CAUSES
Usually, there exists a precocious history of emotional and physical abuse. The patients seem to have problems of identity, intense feelings, inadequate control of the impulses, sense of the deficient reality, brief psychotic episodes and unstable interpersonal relations. The need that attention is paid to them is equal to the incapability to trust in figures of authority, to which they manipulate.
TREATMENT
In the patients of syndrome of Munchausen the treatment rarely is fruitful. To gain access to the manipulations of the patient relieves his tension, but it provokes a climb, exceeding in last stay what the doctors can or are ready to do. To face the patient or to refuse to his treatment demands gives place to reactions of annoyance that lead him to changing hospital. The patient is accustomed to pushing the psychiatric treatment back. Nevertheless the treatment usually comes down to the recognition of the illness and to avoid the procedures that imply risk as the excessive medication.
It is recommended to confront these patients without culpabilizaciones not even reproaches. The doctor must support the condition of real illness, indicating simultaneously the patient that if he cooperates, they can solve the underlying problem. Often it will be necessary to imply some member of the family, in spite of whom tackling the problem like an illness, not like a trick; that is to say, it is not explained to the family what the precise mechanism of the illness is.
TO SEE ALSO
WHAT DOCTOR CAN TREAT ME?
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DEFINITION 
