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Vol 18, No 4 (2021)
Case report
Published online: 2021-02-25
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Münchausen syndrome - case study

Barbara Beata Bylina1, Anna Mosiołek1
Psychiatria 2021;18(4):282-288.


INTRODUCTION Munchausen Syndrome is a type of sham disorder, which causes difficulties in diagnosing process. ICD-10 describes it as psychiatric disorder which is characterized by physical or psychological symptoms that are intentionally produced in order to assume the sick role. However, in order to diagnose someone with ZM, the simulation must be discluded. There cannot be any direct external motivation such as financial benefits. Patients with MS are known by lack of awareness of real motivation for their behavior. They take risk, harmful action in order to interact with the Health Service. It seems that the care they get in medical facilities is a form of gratification for them. Kaplan i Sadock (1995) devided MS into three types: phisical, mental and mixed. Munchausen Syndrome By Proxy is featured, when a patient is projecting symptoms to his or her close one, in most cases – child. CASE STUDY The article is about 26 years old patient, brought up in adoption family. She has been diagnosed with myasthenia gravis and Devica Syndrome and, therefore, currently uses a wheelchair. During her life, patient was undertaking and giving up multiple jobs and studies. What is more, she shows several difficulties in interpersonal relations. The patient was hospitalized for the first time at the beginning of her high school due to self-harm. Second hospitalizations happened two years later, also due to self-harm. Afterwards, during seven years she was hospitalized about 30 times, in only 2019 – 13 times, in multiple medical facilities all over the country. Most of the tome, stays in wards were caused by suicidal thoughts or acts, however, often there were parasuicidal behaviors. Her hospitalizations often had a turbulent course, which was caused by her manipulative and claim attitude. Sometimes the patient had asked for discharge from the hospital on request, and, few days later, was re-admitted to hospital. Moreover, the patient was undertaking several stationary and outpatient therapies, but she was ending them before the therapeutic process was finished. She was diagnosed with border-line personality disorder. In this case both neurological burden and personality disorder are an additional difficulty in diagnostic process.

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