Post on 03-Dec-2015
description
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
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
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