Munchausen SyndromePreceptor : dr. Engelberta Pardamean, Sp.KJComposer : Clarissa Yudakusuma (07120100022)

Kepaniteraan Klinik Ilmu Kedokteran Jiwa - Sanatorium Dharmawangsa – FK UPHPeriode 17 Agustus – 19 September 2015

Definition• Mental disorder

• Fake serious illness(es)

• Produce symptoms using trickery / self-harm

• NOT for personal gain

• Desire for attention and sympathy

Clinical Manifestation

Spectacular medical history

(large number of tests,

procedures and

operations)

Odd collection of unrelated symptoms

No conclusive results despite intense medical investigations

Doctor shopping /Hospital shopping

Failure to improve despite

medical treatment,including

relapsing for unknown reasons

Common Tactics

Pretend to be in pain;exaggerate symptoms

Poison themselves

with chemicals(eg: warfarin,

laxative, insulin)Infect themselves

with unclean substances

Manipulate diagnostic

test(s)

Interfere with a medical condition so that recovery isn’t

possible

Risk Factors• Chronic illness during childhood

• Chronic illness of a family member when the

person was a child

• Relationship, self-esteem or identity problems

• Difficulty distinguishing reality from fantasy

• Ability to lie and manipulate

• History of mental problems: depression,

hallucinations / PTSD

• Traumatic / abusive treatment during childhood

Diagnostic Criteria

Treatment

CognitiveBehaviorTherapy

Medications

Limiting/avoiding

unnecessary medical

proceduresEffective

communication

Familyeducation

PrognosisGOOD

• Responsible for their actions

• Able to increase their problem

solving ability

BAD

• Having high level of denial

• Unable to cooperate with therapy

• Having personality disorder

Differential Diagnosis

Malingering

Somatization

GanserSyndrome

Differential Diagnosis

CharacteristicsMunchausen

SydromeMalingering

Somatization

Ganser Syndrome

Self-awareness of their true condition which is actually healthy

Aware AwareNot

aware

In between(clouding

consciousness)

Motivation / purpose of their action(s)

To getattention / sympathy

Personal gain(eg: money,

time)

Worriness of having certain

disease

To avoid unpleasant situation

Act to produce symptoms using

trickery / self-harmYes No No No