Clinical Case Reports

Biography

Biography: Mayyada Wazaify

Abstract

Background- Münchausen syndrome is a mental illness, in which a person repeatedly acts as if he or she has a physical, emotional or cognitive disorder when, in truth, he or she has caused the symptoms. Although it has been described in the medical literature as “seeking attention” tool, Münchausen syndrome in this case report is also suspected to be the cause for drug addiction. Case descriptions- This was a 45-year-old male patient with multiple medical complains over the years, most of his complaints could not be explained on clinical or organic basis. We believe that his main goal was to justify his drug seeking behavior and to obtain different forms of secondary gains and social security support. The patient was secretly abusing a cocktail of anticholinergic and narcotic drugs which we believe eventually led to his death. He claimed to have chronic headaches and back pain and caused self-harm, such as intentionally opening the surgical wound over his pace-maker, in order to obtain narcotic analgesics. Moreover, he was secretly taking a beta-blocker without any prescription to deliberately induce bradycardia so that he could obtain atropine from the hospital. Conclusion- This case report is important because missing the diagnosis of Münchausen’s syndrome possibly resulted in the inappropriate course of action in his treatment. There could have been some use of psychoanalysis and cognitive behavioural therapy or an addition of a selective serotonin reuptake inhibitor. Moreover, this case reports the abuse of beta blockers for the sake of causing bradycardia and seeking anticholinergic drugs. It is suggested that clinicians consider the specific motivation for drug abuse in all cases of factitious disorders such as Münchausen’s syndrome, and avoid any assumption that it has been carried out for the purpose of controlling genuine symptoms. Involvement of psychiatrists is strongly recommended