How is factitious disorder imposed on self (Munchausen syndrome) treated?

Although a person with this syndrome actively seeks treatment for the various disorders he or she invents, the person often is unwilling to admit to and seek treatment for the syndrome itself. This makes treating people with this syndrome very challenging, and the outlook for recovery poor. If caretakers can protect the patient from self-harm and educate him or her about consequences that can occur, it may be helpful. Trying to reduce his or her care through only one physician, or two working closely together (psychiatrist and internist), is also suggested.

When treatment is sought, the first goal is to modify the person's behavior and reduce his or her misuse or overuse of medical resources. Once this goal is met, treatment aims to work out any underlying psychological issues that might be causing the person's behavior or help him or her find solutions to housing or other social needs.

The primary treatment for factitious disorder imposed on self is psychotherapy (a type of counseling). Treatment likely will focus on changing the thinking and behavior of the individual (cognitive-behavioral therapy). Family therapy also might be helpful in teaching family members not to reward or reinforce the behavior of the person with the disorder, but often the person is estranged from his or her family. Group therapy may reduce feelings of isolation or that no one cares for them.

There are no medicines to treat factitious disorders themselves. Medicine might be used, however, to treat any related disorder—such as depression, anxiety, or a personality disorder. The use of medicines must be carefully monitored in people with factitious disorders due to the risk that the drugs might never be picked up from the pharmacy or might be used in a harmful way.

What are the complications of factitious disorder imposed on self?

These individuals are at risk for health problems (or even death) associated with hurting themselves or otherwise causing symptoms. In addition, they might suffer from reactions or health problems associated with multiple tests, procedures, and treatments, and are at high risk for substance abuse and suicide attempts.

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