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Preparing for your appointment
By Mayo Clinic staffA person with Munchausen syndrome is likely to first receive care for this condition when a doctor raises concerns that psychological problems may be a factor in his or her illness. If your loved one has symptoms that suggest Munchausen syndrome, his or her doctor may contact you in advance to talk about your loved one's health history.
If you think a loved one may have Munchausen syndrome, contact his or her doctor and start the conversation yourself.
Here's some information to help you get ready for that talk.
What you can do
- Write down your loved one's health history in as much detail as possible. Try to include as much as you can remember about the health complaints, diagnoses, medical treatments and procedures your loved one has had. If you have the names and contact information for the doctors or facilities that have provided care, have those on hand for your conversation.
- Write down key points from your loved one's personal history, including major illness, abuse or other trauma that occurred during childhood and any significant, recent losses.
- List the medications your loved one is currently taking, including over the counter and prescription drugs.
- Write down your questions for the doctor in advance so that you can make the most of your conversation.
For Munchausen syndrome, some questions to ask the doctor include:
- What is likely causing my loved one's symptoms or condition?
- Are there other possible causes for these symptoms or condition?
- How will you determine the diagnosis?
- Is this condition likely temporary or chronic?
- What treatments are recommended for this disorder?
- How much do you expect treatment could improve the symptoms of Munchausen syndrome?
- How will you monitor my loved one's well-being over time?
- Do you think family therapy will be helpful in this case?
- What next steps should we take?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your conversation at any time that you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- What injuries or illness has your loved one recently complained of?
- What injuries or illnesses has he or she been treated for in the past?
- Has your loved one been diagnosed with any specific medical problem?
- What treatments has he or she had, including drugs and surgery?
- How often has your loved one switched doctors or hospitals in the past?
- How have your loved one's symptoms affected his or her career and your personal relationships?
- Do you know if he or she has ever caused self-inflicted injury or attempted suicide?
- Do you know if your loved one was abused or neglected as a child?
- Did he or she suffer any other trauma, such as serious illness or loss of a parent, during childhood?
- What else makes you suspect that your loved one may have Munchausen syndrome?
- Have you talked to your loved one about your concerns?
What you can do in the meantime
Confronting your loved one directly about Munchausen syndrome is not likely to help, but it may help to simply express your desire to help find an explanation for his or her health problems. It also may help go with your loved one to the first appointment.
If your loved one causes self-inflicted injury or tries to commit suicide, call 911 or take him or her to an emergency room immediately.
- Factitious disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 24, 2009.
- Eisendrath, SJ. Factitious disorder (including Munchausen's syndrome). In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/128035876-3/821157946/1701/215.html#4-u1.0-B978-0-323-04134-8..50009-4--subchapter1_4547. Accessed March 24, 2009.
- Hamilton JC, et al. Factitious disorders and malingering. In: Gabbard GO. Gabbard's Treatments of Psychiatric Disorders. American Psychiatric Association; 2007. http://www.psychiatryonline.com. Accessed March 24, 2009.
- Purcell TB. Factitious disorders and malingering. In: Marx JA, et al., eds. Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo.: Mosby; 2006. http://www.mdconsult.com/das/book/body/128035876-4/821158282/1365/348.html#4-u1.0-B0-323-02845-4..50117-7--cesec4_5748. Accessed March 24, 2009.
- Factitious disorder and malingering. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed March 24, 2009.
- Lipsitt DR. Factitious disorder and Munchausen syndrome. http://www.uptodate.com/home/index.html. Accessed March 24, 2008.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. March 26, 2009.
