Skip to Factitious Disorders &
Munchausen Syndrome.
Skip to Munchausen Syndrome by
Proxy.
Skip to Obtain Books on the
Subject, Including Dr. Feldman's New Book for the General Public, PLAYING SICK.
Skip to The Munchausen Tales.
Skip to Dr. Feldman's Non-Munchausen Book, "Stranger Than Fiction: When Our Minds Betray Us."
ATTORNEYS ONLY:
Click to visit Dr. Feldman's site only for attorneys.
***Dr. Feldman's newest book, PLAYING SICK, is NOW AVAILABLE for order at a big discount. It covers all the topics dealt with on this page. Find it at Amazon.com by searching for "Playing Sick"***
Dr. Feldman can vouch only for the material in the
links below that he has personally written. He appreciates hearing about individuals' experiences with the
phenomena discussed on this page, but cannot always respond.
His email address is mdf@myself.com.
I am a psychiatrist and author from Birmingham,
Alabama. MUNCHAUSEN SYNDROME is the most severe and chronic
form of my area of specialty, the FACTITIOUS DISORDERS. I am
an expert in MALINGERING as well (in which people do the same
thing, but for external gain such as narcotics). Factitious
disorders are well-recognized among psychiatrists, but they
have not received the attention--or advocacy among consumers,
families, and professionals--that have greeted more common
ailments such as depression. However, factitious disorders
can be every bit as disabling and further public and
professional education are vital.
People with factitious disorders feign, exaggerate, or
actually self-induce illnesses. Their aim? To assume the
status of "patient," and thereby to win attention,
nurturance, and lenience that they feel unable to obtain in
any other way. Unlike individuals who "malinger," people with
factitious disorders are not primarily seeking external gains
such as disability payments or narcotic drugs--though they
may receive them nonetheless.
-
In "MUNCHAUSEN SYNDROME BY PROXY" (MSBP), an
individual makes another person sick in order to accrue the
same gains--but this time vicariously. This is a form of
abuse in which children are the usual victims.
FACTITIOUS DISORDERS, INCLUDING
MUNCHAUSEN SYNDROME
Click for a
brief overview article on the subject, "Disease or Deception?
The Mystery of Factitious Disorders."
Click for another
one-page article about factitious disorders (note that treatment through
long-term hospitalization is very controversial).
Click for a medical dictionary entry on Munchausen
syndrome.
Click
for the Merck Manual entry on Munchausen syndrome.
Click for a
woman's first-hand account of factitious
disorder.
Click for a brief 2002 article about Munchausen syndrome.
Click for a
site devoted to factitious psychological
disorders.
Click for a case of
factitious bereavement.
Click for an
academic article about Munchausen syndrome and MSBP by
Internet.
Click
for a brief article about so-called Munchausen by
Internet.
Click for
a longer article from a major newspaper about Munchausen by
Internet.
Click for a
report about children and adolescents with factitious
disorder.
Click
for an article illustrating the international dimensions of
factitious disorders.
Click
for an article about a recovered Munchausen
patient.
Click for a first-hand account about a Munchausen patient (skip
to section headed "A Case of 'Munchausen'").
Click
for a brief article about factitious Cushing's
syndrome.
Click for a case report of
a factitious clotting disorder.
Click
for an abstract about factitious dental
problems.
Click
for an abstract about the use of aliases in factitious
disorder.
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Top
MUNCHAUSEN SYNDROME BY
PROXY
Click for
an overview article about MSBP.
Click for a
website founded by an adult survivor of MSBP
abuse.
Click for a MSBP
consultant's website.
Click for
a Dutch site on MSBP.
Click for a
30 minute television show on MBP on which Dr. Feldman appears (wait for the RealPlayer download).
Click for information about the case of Kathy and Jennifer Bush.
Click for
more background information about this famous case.
Click for
a short article about the failed appeal in the Bush
case.
Click for an
excellent self-study module on MSBP that is intended primarily
for nurses and includes a quiz.
Click for a
pediatrician's brief review article about MSBP.
Click
for an abstract illustrating how drug monitoring can help
detect MSBP.
Click for
an article that points out some of the factors underlying MSBP abuse
and the barriers to its being recognized and reported.
Click for a lengthy
PDF law-journal article about potential physician liability in MSBP cases.
Click for an
investigative series about apparent SIDS, apnea, and serial
suffocation in MSBP.
Click for a new
American Academy of Pediatrics policy on the risks of
misdiagnosing fatal child abuse as SIDS.
Click
for an article about a California mother who used MSBP as
a defense in her child abuse trial.
Click for information on why
some victims seemingly collude in their own MSBP abuse (skip to the "Stockholm syndrome"
section).
Click to read about a legal case in which the mother admitted
to the MSBP abuse.
Click for an
article that notes that MSBP has been found
internationally.
Click for an
article that argues that false allegations of victimization of a child, such as
sexual abuse, can be a variant of MSBP.
Click for an
article I co-authored on MSBP presenting as child sexual abuse. It contains a discussion
of general MSBP intervention and management.
Click for a Texas case
(Cynthia Martinez, aka Cynthia Lyda) in which custody and visitation were contested.
Click for more information about this case.
Click
for another article about this case, in which the mother
ultimately pled guilty to abuse.
Click for the website of an MBP survivor
who has published her memoir.
Click
for an article about a Philadelphia case in which the mother
killed 8 of her own children in a pattern suggesting
MSBP.
Click
for the transcript of an online chat with Dr. Feldman.
Click for an overview of
investigative issues for law enforcement in MSBP
cases.
Click for an abstract about misdiagnoses of
MSBP.
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Top
What do patients with factitious disorders and those
who engage in Munchausen syndrome by proxy do? They
deliberately mislead others into thinking they (or their
children) have serious medical or psychological problems,
often resulting in extraordinary numbers of medication
trials, diagnostic tests, hospitalizations, and even surgery
. . . that they know aren't really needed. In short,
factitious disorders, like malingering, involve "disease
forgery."
-
They may feign illness--e.g., fake having a
seizure.
-
They may falsify lab results--e.g., by adding blood
or protein to a urine specimen.
-
They may aggravate an existing medical
problem--e.g., by manipulating a wound so it doesn't
heal.
-
Or they may induce an actual illness--e.g., by
injecting themselves or their child with bacteria to cause
a raging infection.
In unusual variants, some seek the HERO or VICTIM
role, rather than the SICK role. The good news is that
knowledge about factitious disorders has been increasing
exponentially.
Click to order
my newest book, "PLAYING SICK: UNTANGLING THE WEB OF MUNCHAUSEN SYNDROME,
MUNCHAUSEN BY PROXY, MALINGERING, AND FACTITIOUS DISORDER." (type "Playing Sick"
into the Search box for books and scroll down).
Click to order a
book that I've co-edited on factitious disorders and MSBP, "THE
SPECTRUM OF FACTITIOUS DISORDERS" (click on SEARCH in the left frame, then type "Feldman"
into the Search box).
Click to
search booksellers for a book on the subject that I
co-authored for the general public, "PATIENT OR PRETENDER: INSIDE THE STRANGE WORLD OF
FACTITIOUS DISORDERS" (type "patient pretender" into the Title Search
box).
Click to
order an excellent fictional account of MSBP, "ALMOST LOVE, ALMOST
DEATH" (type title words into the Search box).
Back to the
Top
THE MUNCHAUSEN
TALES
The term "Munchausen syndrome" was derived from
the storybook character created by Rudolph Erich Raspe. In turn, the
character was based on a real 18th century Prussian cavalry officer, Karl
Friedrich Hieronymus Freiherr (Baron) von Munchhausen
(1720-97).
Click
on this spot for a very thorough discussion of the origin of the Baron's
tales.
Click for even more background in a rambling piece about the first publication of the
tales.
The tales of Baron Munchausen were adapted as a
1989 film by director Terry Gilliam.
There had also been a 1979 Russian version, a
1943 German
version, a 1911
French version, a 1961 Czech version, a 1933 American
version, and a 1989 Canadian version.
A card
game is named for the Baron, and trading cards
with his name have become collectibles. There even used to be a musical group called
"Martin Munchhausen and the Polka Barons."
Back to the
Top
Dr. Feldman's book, "STRANGER THAN
FICTION: WHEN OUR MINDS BETRAY US," describes mental illness
from the perspective that these disorders are actually
variations of universally shared thoughts, feelings, and
behaviors. Click to order "STRANGER THAN FICTION"
(type "Stranger Betray" into Search
Form).
If the book is back-ordered, try this link.
Thank you for your interest!
Copyright ©2004, 2005, 2006 by Marc D. Feldman,
M.D.
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