Munchausen Syndrome

[kabenkula]

I recently had a patient diagnosed with Munchausen Syndrome admitted to the surgical floor for surgery. This patient was placed on suicide precautions. Because I don't know much about this sydrome, does anyone know if they are at an increased risk for suicide? I thought that with this syndrome, the patient was more interested in gaining attention versus actually committing suicide. Does anyone have any information for me that could help in the future?

[elkpark]

I would guess, without knowing anything else about the situation, that she was placed on suicide precautions so that she would be continuously (or v. frequently) observed, not because of a fear that she wants to kill herself but because of the risk of her doing other non-lethal but dangerous things to herself -- but "suicide precautions" are what that level of observation is called at that facility, so that's how the order is written.

[morte, LPN, LVN]

I would guess, without knowing anything else about the situation, that she was placed on suicide precautions so that she would be continuously (or v. frequently) observed, not because of a fear that she wants to kill herself but because of the risk of her doing other non-lethal but dangerous things to herself -- but "suicide precautions" are what that level of observation is called at that facility, so that's how the order is written.

exactly what i was thinking....this was the way to get her the care that she required..

[melmarie23, MSN, RN]

I guess it depends on what they were doing in order to get attention.

what is the scheduled surgery?

[sirI, MSN, APRN, NP]

These individuals are at risk for "accidental" suicide. Many will try and exacerbate their symptomology by self-inflicting wounds (opening surgical wounds), ingesting substances (injecting pus in an IV, wound), avoid early treatment of a real problem in order for the condition to become serious, etc. Thus, the suicide precautions necessary in their care.

Mortality/Morbidity

Although patients with Munchausen syndrome are generally medically knowledgeable and sophisticated, their manipulations sometimes result in unintended serious injury, permanent disability, or death.

http://emedicine.medscape.com/article/295127-overview

[NSALVADORE]

The previous posters did a good job explaining why. I'm curious, how interesting to get this case.. Did she talk to you at all about her condition???

[kabenkula]

This patient was scheduled for abdominal surgery to have the bracelet removed that she inserted into her abdomen. My shift ended before she went to surgery, and I haven't worked since, so I don't know about the patient's post-op status.

[ChuckE]

Munchausen is much better than Munchausen by PROXY!

[diane227, LPN, RN]

Hard problem to treat. I have seen a lot of people with this problem and it is very often fused with borderline personality disorder. High risk for accidental suicide.

[kabenkula]

Sorry, I'm so late in responding. No, she didn't talk about her condition. She just mentioned that she had had previous stomach surgeries and during my assessment, noticed several scars on her abdomen.