Munchausen syndrome - a case series at Camp Jail Lahore, Pakistan

Abstract

INTRODUCTION: Munchausen syndrome is a rare condition where individuals intentionally simulate illness despite the absence of actual symptoms. The objective of our case series was to underscore the importance of recognizing this mental disorder, frequently overlooked in routine clinical practice.

CASE PRESENTATION: This case series presents eight inmates in a central jail in Lahore, Pakistan, diagnosed with Munchausen syndrome within a period of one year (February 2019 to March 2020). Cases include a death row inmate complaining of abdominal pain, investigations revealing no pathology, and subsequent self-harm; a drug user with recurrent rectal bleeding resorting to self-inflicted injuries; prisoners intentionally causing head injuries, resulting in a fatality; a chest pain complaint used as a diversion for escape; a prisoner with a recurring leg ulcer engaging in self-mutilation; ingestion of a shaving blade; simulated sexual activity for admission; and inmates faking severe chest pain for medical attention.

CONCLUSION: The study highlights diverse manifestations of Munchausen syndrome in a jail setting, emphasizing the need for psychological evaluation and management. In constructing a differential diagnosis for diverse pathologies, it's important to consider Munchausen syndrome, especially when confronted with a cluster of signs and symptoms that prove difficult to elucidate.