munchausen vs malingering

malingering

when somebody pretends or deliberately makes themselves unwell for an incentive (eg. avoid criminal prosecution, skip school)

munchausen syndrome

when a person pretends to be ill or deliberately produces symptoms of illness in themselves, their main intention to assume the “sick role” so people care for them and they are the center of attention.

aleem and ajarim sample

22 y/o female uni student initially suspected of having immune deficiency

aleem and ajarim sample background

• first presented at 17 with amenorrhea; was prescribed meds

• overtime developed recurrent deep vein thrombosis

• hospitalized for various unexplained symptoms (eg. swelling in groin, breast abscesses) requiring numerous surgeries

aleem and ajarim discovery

• even after extensive testing, no medical cause found, suspicion of munchausen arose

• led to psychiatric consultation, where patient was defensive and stressed

• nurse discovered evidence that patient was self-inflicting

• patient got angry, left against medical advice, lost to follow up

aleem and ajarim pros

• confidentiality

• in-depth

• useful for understanding

aleem and ajarim cons

• generalisability

• potential harm to patient

main features of munchausen

• pathalogical lying

• peregrination between docs

• recurrent, feigned, or simulated illnesses

supporting features

• [borderline] anti-social personality traits

• childhood deprivation

• emotional stability during procedures

• self-induced signs

• knowledge in med

• multiple hospitalizations

• multiple scars (typically abdominal)

• criminal record

• dramatic presentations