Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

The Munchausen Syndrome in the context of modern medicine: a case study of a patient pursuing Bone Marrow Transplantation (126399)

Marta Pawełczak-Szastok 1 , Małgorzata Sobczyk-Kruszelnicka 1 , Katarzyna Świerzko 2 3 , Sebastian Giebel 1
  1. Department of Bone Marrow Transplantation and Oncohematology, M. Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland, Gliwice, Silesia, Poland
  2. M. Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland, Gliwice, Silesia, Poland
  3. „Dąbrówka” Center for the Treatment of Neuroses and Eating Disorders, Gliwice, Silesia, Poland

The Munchhausen Syndrome (MS) is a well-known, long-described syndrome characterized by feigning somatic or psychological disorders. Classic classifications distinguish different types of MS: abdominal, hemorrhagic, neurological, and dermatological. Increasing access to reliable medical knowledge among the general population has led to the appearance of MS in medical fields previously not associated with it.

The case study described involves a 26-year-old patient who simulated the presence of serious immunological disorders, resulting in her being qualified for a bone marrow transplant procedure (BMT) from a unrelated donor. Upon admission to the Bone Marrow Transplant Clinic, the patient exhibited strong excitement, which the attending physician found to be inappropriate for the situation, prompting a referral for psychological consultation.

A clinical psychological diagnosis based on interview and observation revealed, among other things: infantilism, high emotional tension, inappropriate emotional reactions (e.g., when discussing the risks associated with the transplant, the patient showed no fear but excitement), dishonesty, fear of being exposed, fixation on health,  illness and secondary gains topics (such as justification for avoiding developmental tasks and eliciting sympathy from others). Additionally, abnormalities in family functioning were identified, including intense rivalry among adult children for the position of the sick person.

These psychosocial functioning features led the psychologist to suspect MS. The psychologist’s diagnosis was confirmed by the consulting psychiatrist. An in-depth analysis of the medical documentation by the treating physician also confirmed the possibility that the patient might manipulate information provided to various specialists involved in her referral to the transplant center. As a result, the patient was disqualified from BMT treatment.

This case study highlights the importance of interdisciplinary collaboration and the role of a clinical psychologist in the process of diagnosis and patient qualification for treatment—also in strictly somatic fields.

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