Illness falsification has been included in pediatric literature in the last 20 years. The differential diagnosis in children persistent, laboratory findings, and even unexplained symptoms have been recognized by caregivers. However, there is less awareness that adolescent and child patients can be intentionally falsified by pediatric symptoms, prompting the two groups to remain virtually invisible. Reports have shown that many children who have the factitious disorder are also suffering from other mental disorders and most personality disorders. For instance, it was reported a case in which a 15 years old patient who was having sickle cell disease was also having Munchausen's syndrome. The aim of this paper is to make clinicians to be aware of this unknown disorders in children and to discuss the differences and similarities of those disorders in adults compared to children with the same.
Children patients with the factitious disease are frustrated but the adult who has same disorders are at times challenged. The differential diagnosis in children persistent, laboratory findings, and even unexplained symptoms have been recognized by caregivers. Currently, there is lacking awareness when it comes to the adolescent and child patients whereby they are being intentionally falsified by pediatric symptoms. Many cases of adolescent and child illness falsification have been reported in many US states and worldwide (Decker, 2013). Many of the Munchausen syndrome by proxy mothers, in fact, have been described in inducing themselves in their teenage years with this illness (Decker, 2013).
It covers a group of mental disorders or disturbance, in which patients act intentionally ill mentally or physically without any obvious benefits. This leads to waste of medical resources through unnecessary tests. Factitious disorders are sometimes called hospital addition, postsurgical addition, or pathomimia. Factitious disorders are different from malingering, which is described by faking illness with the clear motive of avoiding legal proceedings or gaining financially. Alternatives names for patients with Factitious disorders (FD) include problem patients, hospital vagrants, professional patients, and peregrinating patients.
Factitious disorders symptoms range from mild exaggerated of symptoms to severe. The patients may come up with symptoms or even tamper with laboratory test in order to convince the medical specialist that high risky treatment or surgery is the only option. Although factitious disorders patients know they are faking illness or symptoms, they do not understand the reasons for their behavior. FD is hard to treat and very mysterious. Nevertheless, psychological and medical help is very critical in order to prevent an individual from serious injury or even death caused by self-injury of this disease.
Many individuals with factitious disorders suffer from mental illness, but mostly personality disorders. People with this disorder, have long patterns of acting and thinking that differ from normal or what society prefer as usual (Cockerham, 2016). It is considered as the mental disorder because people with this illness will experience severe emotional difficulties. These people have the problem and poor skills in forming the healthy relationship with other people. This disorder is similar to somatic disorder, which involves the presence of disorders that are not there due to actual physical illnesses. People with this disorder do not fake illness intentionally or even mislead others about their symptoms.
The causes of factitious disorders is not well known, however, researchers believe that both psychological and biological factors have the role in the development of this disorder. Some theories say that history of child abuse and neglect or history of frequent hospitalization may be the cause of their development.
To treat, this disorder is to reduce his or her misuse of medical resources and modify the patient's behavior. The safety and protection of potential or real victims are provided, then the underlying psychological issues are tried to be resolved which are causing that individuals behavior in order to find the solution to social or housing needs. The initial stage is psychotherapy a type of counseling.it try to change the behavior and thinking of those people. Also, family therapy also is important in teaching members of the family not to reinforce or reward the behavior of the individual with this disorder.
There is no medication to treat FD. Only those related symptoms are treated like anxiety and depression. Medication must be monitored carefully in order to reduce the risk of harming individual when picked from a pharmacy. People with FD are at risk of self-harm problems associated with injuring themselves. And in addition, they usually suffer from multiple tests, treatment and procedures with can lead to substances abuse and suicidal thoughts.
Munchausen's syndrome was named after Freiherr Von Munchausen, Karl Frederick Hieronymus, and Germany cavalry officer.it is the subset of patients with the chronic variety of factitious disorder with symptoms and predominately physical signs. Munchausen's syndrome is the mental or psychological disorder, where individual pretends to be ill he or she produces deliberately symptoms of illness and causes severe emotional difficulties(Feldman, 2013).they do this in order for people to care and became a center of attention for them and results to unnecessary and expensive medical checkups.
People with Munchausen's syndrome can have different ways of behaving which includes: actively trying to get ill, pretending to have physical symptoms, and pretending to have psychological symptoms .they spend time from on hospital to another with very range of symptoms. They are very manipulative and they take risky surgery which is very painful, even if they knows it is cases is unnecessary.
Munchausen's syndrome is poorly understood and complex. Individual refuse psychological profiling or psychiatric treatment, and it is uncertain why that it this disorder behave that way. Case studies and researchers have tried to identify the cause of this syndrome. Some of the causes include: illness during childhood or emotional trauma, personality disorder, and even grudge against health professionals or authority. Emotional trauma to the child is caused by parental abandonment and neglect. This usually makes them have unresolved issues with parents and the only way to punish them is to fake illness in order to make them responsible towards them.
Munchausen's syndrome is also caused by prolonged or extensive medical attention during childhood or even adolescence stage. This is because they want to feel them like childhood memories of been cared by and they can reassure only be being ill. This ill brings acceptances and unconditional support. People with this disorder, have difficulties relating with others, hence having the problem in establishing strong and manful relationship .when they are admitted to a hospital it becomes a social network to them due to sympathy from people.
It is challenging to Diagnosing Munchausen's syndrome. This is because people with this syndrome are very skilled in exploiting and manipulating medical professionals. Healthcare giver runs the test to check evidence of the said illness and also go through health records of the patients to look for the inconsistencies claimed and even contact family members in order to know actual medical history. Patients are referred to specialist psychiatric if they admit lying, in order to establish the cause of their anxiety and stress. The combination of psychoanalysis and cognitive behavioral therapy has bared some success in control the symptoms and helping them. Family therapy is also important, hence family members should be close to them in order to support the emotion and to understand the causes of faking that illness (Berger, 2013).
Munchausen Syndrome by Proxy
Munchausen's syndrome by proxy is a mental health problem. Whereby caregiver mostly mothers causes illness or injury to the victim under their care. It is a form of elder or child abuse. The victims are mainly persons with disability, elderly adults, and even child. The caregiver may lie about child's symptoms, cause physical harm to a young child in order to produce symptoms, and even change child's test to make appear ill.
Many of the victims are young children. They may undergo the very painful medical test which is unnecessary. Caregiver may injure them, make them seriously ill, or they may die from the action of caregivers. Many children who are victims of Munchausen's syndrome by proxy can sustain emotional and lifelong physical problems and they may end up having Munchausen syndrome when they grow old.
The causes of Munchausen's syndrome by proxy is not clear what cause it. Doctors link it to the problem during the childhood of the abusers. Abusers have poor self-esteem, which makes them to feel if their life is out of control leading to anxiety and stress (Brockington, et al., 2011, pp.93-102).
Munchausen's syndrome by proxy is treated from involving the doctors, law enforcement, and child protective services. Those caregivers with this condition need counseling. They may deny or resist from having that illness. Medications are not used, but only when the patients have other health problems like the anxiety disorder. The family needs to monitor the caregiver very closely and the victims who are mostly children needs to be taken to safe custody, although some children require counseling.