Munchausen Syndrome In a Teenager. A Case Report

Smaranda Diaconescu, M. Burlea, Amalia Constantin, Gabriela Paduraru, Claudia Moscalu, Smaranda Bunea, V. V. Lupu

Authors present a case of Munchausen syndrome, a factitious disease of unknown etiology in a teenager girl aged 17. The patient has been diagnosed with Helicobacter pylori associated gastritis successfully treated in our clinic, with normal endoscopic aspect and negative CLO-test and microscopy at two month check-up. She has two suicide attempts, a voluntary ethylic alcohol intoxication, followed by multiple admissions into different services from our hospital (gastroenterology, cardiology, nephrology, surgery) and in other hospitals (Infectious Diseases, Neuropsychiatry). She frequently addressed to the hospital, with various complaints usually worsening after standard therapy (peregrination). The total number of hospitalizations was 34 (166 days) in 3 years. Another characteristic of the disease, „pseudologia fantastica‖, was also present; the girl told different stories about her family, about one of her friend’s death and about a rape that she was victim of. Psychological and psychiatric examination showed medium IQ, sadness, low level of self-esteem, anxiety and depression. Risk factors for the disease were identified: separation from the mother in early childhood, emotional neglect, physical and possibly sexual abuse. Psychological counseling and anti-depressive therapy were initiated, but medication has to be stopped because the girl left home and the treatment can’t be continued without an adult surveillance. The patient is lost from our evidence because she changed her residence (another behavioural pattern of the disease), but she will probably be found in the next years in the records of various adult clinical services.

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