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What Is Munchausen Syndrome? Would You Recognize A 'Self-Inflicted' Oral Disease?

What Is Munchausen Syndrome? Would You Recognize A 'Self-Inflicted' Oral Disease?
by Nancy W. Burkhart, BSDH, EdD

Munchausen syndrome is a severe form of a factitious disorder in which a person has recurrent, feigned, or self-inflicted illness to gain medical attention (Little, 2016). The term "Munchausen syndrome" is named for the German Baron von Munchausen and described by Dr. Richard Asher in an article published in Lancet (1951). In his "Talking Sense" trilogy, Dr. Asher described three typical cases.

As described by Asher (1951), the patient may present with a multiplicity of scars-often abdominal-an immediate history that is always acute and harrowing, an evasive manner, a wallet or handbag stuffed with hospital attendance cards, insurance claims, and litigious correspondence.

The paper was originally written in the early 1950s and admissions have changed greatly since that time. Hospital procedures currently use online documentation in most cases. Hospital personnel would begin to recognize frequent visitors to clinics and emergency rooms. Generally, a patient may attempt to convince health-care providers of an existing disease state to maintain the health-care providers' interest. A self-inflicted injury is usually found, and the patient may invent ways to keep the disease in a worsening state with the goal of managing to be treated again and again.

In a study by Bass and Jones (2011), over half of the participants had histories of self-harm beginning in adolescence, and some continued into adult life. They are usually women and many have been involved in some type of health-care work themselves. The connection with health care may provide some insight into terms and body/health functions.

Munchausen's is also used in a form of child abuse in which "the care giver intentionally overstates, contrives, and/or creates a physical, emotional, or behavioral problem in the child" (Neville et al., 2016). The abuser presents a contrived effort to make the child appear sick to gain attention with health-care providers. The term used in this case is Munchausen syndrome by proxy (MSBP), also recently named "fabricated or induced illness."

It is believed that many individuals who exhibit these bizarre behaviors in Munchausen as well as MSBP were abused themselves as children. It is a form of child abuse in which the parent presents the child to a health-care provider with false claims of sickness or disease, knowingly falsifying their role in this development. Factitious injury may be either self-induced or deliberately caused either subconsciously or unconsciously.

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