Tag: sick

Posted in Psychology & Medicine

Symptom Reporting

Posted on by Jinavie

Some people always complain of symptoms, claiming that they are sick, while some people never seem to complain even if they have a whole list of symptoms. Why is there a difference in symptom reporting between people? For example, women are more likely to recognise symptoms and report them compared to men. This is because men are generally under the social pressure of needing to appear strong and healthy, so they become stoic and less sensitive to pain and disease. Women are usually more sensitive to internal bodily changes and worry more about their health.

According to a psychological theory called the competition for cues hypothesis, there are two signals that compete for attention when we recognise symptoms. The first is bodily changes, i.e. internal cues, while the other is external stimuli from what happens around us. Awareness of symptoms follows a ratio between these two signals: if there is a strong internal cue such as severe pain, we notice symptoms more quickly, while if there are many distractions, we may not notice the symptom. For example, according to a study people can run faster when listening to music and running through a forest with plenty to see. This is because music and the scenery distract the runner from internal cues. As we can only process a certain amount of information at a given moment, the more distractions there are the less sensitive we become to signals from inside our body.

Another factor that affects symptom reporting is illness labelling. The more information we have about a disease, the more we search for those symptoms. For example, if you yawn or scratch yourself, people around you will do the same. This is because they see you yawning and subconsciously believe that they should yawn too. This can be a powerful effect, as seen in mass hysteria. This strange phenomenon occurs when a person observes a sick person and their brain believes they are sick too, beginning to show symptoms despite being healthy. A similar example is seen in medical student disease, where medical students, with their extensive knowledge of diseases, match their own symptoms to symptom lists of rare diseases. For example, they might think that their high blood pressure is due to a phaeochromocytoma or renal artery stenosis, rather than just hypertension.

However, the opposite can occur where people fail to notice important symptoms and suffer serious consequences as a result. For instance, not all cases of heart attacks (myocardial infarction) cause unconsciousness and a patient may believe they are fine when only chest pain occurs. Failure to get treated as soon as possible at a hospital may result in ventricular fibrillation, leading to sudden death.

Posted in Psychology & Medicine

Munchausen’s Syndrome

Posted on by Jinavie

Some people are known to overreact regarding their health, such as a hypochondriac thinking that she has kidney failure because her urine looks slightly frothier. However, some people far surpass the level of hypochondrias to the level of psychiatric disease.
Münchausen’s syndrome patients are known to exaggerate or create symptoms so that the doctor would pay attention to them. When the doctor investigates, treats and sympathises with the patient they gain satisfaction from all the attention they are receiving.
Although this may sound like hypochondrias, Münchausen’s is far more serious.

A Münchausen’s patients are known to cause symptoms just to get attention from others. For example, a common manoeuvre used is the injection of insulin to induce a hypoglycaemic seizure. When their symptoms are “treated”, the patient will most likely invent another factitious disease to be treated for a longer time. They will also seek out many different doctors when the attending doctor catches on to their act. In fact, a Münchausen’s patient will do almost anything to prolong medical care, even accepting unnecessary and risky procedures such as surgeries.

The key difference between Münchausen’s syndrome and hypochondriasis is that the patient is aware that they are not actually sick (hypochondriacs actually believe they are sick). The fundamental basis for Münchausen’s syndrome is the desire for attention. Thus, the main risk factor for developing Münchausen’s is childhood experience of seeing someone close (typically a family member) suffering a debilitating disease. For example, if a girl sees her sister suffering from leukaemia and receiving all the attention of everyone around her, she may develop feelings of jealousy and later try to duplicate the scenario. As a patient, the person feels safe and comfortable and this feeds their addiction to medical care.

As Münchausen’s patients are very proficient liars and act completely like an actual patient, doctors must rule out any diseases before suspecting that their patients have a psychiatric problem. However, some signs such as the patient being overly keen on receiving procedures such as biopsies or continuously developing random symptoms may indicate Münchausen’s.

Interestingly, a similar condition called Münchausen’s syndrome by proxy also exists, where a caregiver (e.g. mother) convinces a doctor that the person they are caring for (e.g. child) are sick. Unfortunately, as these patients actually cause illness in the child, it is considered a form of child abuse. Common “symptoms” include: growth problems, asthma, allergies, vomiting, diarrhoea, seizures and infections. This may lead to the child developing Münchausen’s syndrome in the future.