Talk:Munchausen by Internet

Further searching for sources

The following was copied in part from my talk page archives here, and placed here as a guide for others who are interested in reading reliable sources and searching for more information. Citations crossed out have been cited in the Wiki article. --Moni3 (talk) 14:54, 9 March 2010 (UTC)

Munchausen's syndrome by Google.Citation Only Available (eng; includes abstract) By Griffiths EJ, Kampa R, Pearce C, Sakellariou A, Solan MC, Annals Of The Royal College Of Surgeons Of England [Ann R Coll Surg Engl], ISSN: 1478-7083, 2009 Mar; Vol. 91 (2), pp. 159-60; PMID: 19317939 Database: MEDLINE with Full Text

The article addresses a woman who complained of persistent ankle dislocation, with a history of multiple hospital visits in Australia and the UK, who presented to doctors with an X-ray copy she printed from the internet. The article alerts physicians to the possibility that factitious disorder patients may be getting information from the internet that they use to exaggerate their claims.

Delusional parasitosis facilitated by web-based dissemination.Citation Only Available Vila-Rodriguez, Fidel; Macewan, Bill G.; American Journal of Psychiatry, Vol 165(12), Dec, 2008. pp. 1612. [Letter] Database: PsycINFO

This is a letter discussing a 57-y.o. male with a past of drug abuse and schizophrenia who was convinced he had parasitosis, and a family of a 2-year-old who launched an unprecedented publicity and lobbying campaign to find the name of a condition that clinical perceptions acknowledge to be delusional parasitosis. The 57-y.o. presented himself as having the same condition as the 2-year-old after reading about it on the internet. The letter writers' point is that the internet can mislead patients, and when people go online or participate in support groups with others who confirm their diagnostic fears, such communities can perpetuate false perceptions and they become delusional when a community supports their concerns.

{Münchausen syndrome with forgery on biologic results. A case report}Citation Only Available Pseudoleucémie par falsification d'examens biologiques: genèse d'un syndrome de Münchausen. (fre; includes abstract) By Thabuy F, Marzac C, Renaud MC, Fardet L, Tiev K, Tolédano C, Texier PL, Cabane J, Kettaneh A, La Revue De Médecine Interne / Fondée ... Par La Société Nationale Francaise De Médecine Interne [Rev Med Interne], ISSN: 0248-8663, 2008 Nov; Vol. 29 (11), pp. 924-8; PMID: 18387714 Database: MEDLINE with Full Text

In French.

A simulated case of chronic myeloid leukemia: the growing risk of Munchausen's syndrome by internet.Citation Only Available (eng) By Caocci G, Pisu S, La Nasa G, Leukemia & Lymphoma [Leuk Lymphoma], ISSN: 1029-2403, 2008 Sep; Vol. 49 (9), pp. 1826-8; PMID: 18608864 Database: MEDLINE with Full Text

Article describes doctors' experiences with a 44-year-old woman presenting herself with documentation attesting that she had chronic myeloid leukemia. Questioning by doctors of the patient and of the records discovered that the woman had "skillfully falsified" charts, and lied about previous visits to other clinics, going so far as to write letters on the behalf of doctors she had never seen, insisting that the patient (herself) not be told that her medical history had been lost. Patient was a skilled user of the internet, and authors labeled this case as Munchausen by Internet, but did not say that the patient expressed her medical concerns over the internet, just used it to create false medical records for real doctors. Article discusses causes of Munchausen syndrome and the difficulties of treating patients with factitious disorder.

Legal issues surrounding the exposure of 'Munchausen by Internet.'Citation Only Available Feldman, Marc D.; Peychers, M. E.; Psychosomatics: Journal of Consultation Liaison Psychiatry, Vol 48(5), Sep-Oct, 2007. pp. 451-452. [Letter]Database: PsycINFO Full Text from ProQuest

Legal issues surrounding the exposure of "Munchausen by Internet".Citation Only Available (eng) By Feldman MD, Peychers ME, Psychosomatics [Psychosomatics], ISSN: 0033-3182, 2007 Sep-Oct; Vol. 48 (5), pp. 451-2; PMID: 17878508 Database: MEDLINE with Full Text Full Text from ProQuest

Factitious Ovarian Cancer: Feigning via Resources on the Internet.Citation Only Available Levenson, James L.; Chafe, Weldon; Flanagan, Phelicia; Psychosomatics: Journal of Consultation Liaison Psychiatry, Vol 48(1), Jan-Feb, 2007. pp. 71-73. [Journal Article] Database: PsycINFO Full Text from ProQuest

Article discusses a woman who presented to doctors with ovarian cancer after researching on the internet. Does not discuss manifestation of presenting a medical crisis over the internet.

Forensic web watch--medicolegal aspects of paediatric pathology.Citation Only Available (eng; includes abstract) By Liggett A, Swift B, Journal Of Clinical Forensic Medicine [J Clin Forensic Med], ISSN: 1353-1131, 2003 Sep; Vol. 10 (3), pp. 201-4; PMID: 15275022 Database: MEDLINE with Full Text

Article discusses internet coverage of child abuse cases in the area of pediatric forensic pathology. It mentions Munchausen Syndrome by Proxy.

Munchausen's syndrome by proxy web-mediated in a child with factitious hyperglycemia.Citation Only Available (eng) By Vanelli M, The Journal Of Pediatrics [J Pediatr], ISSN: 0022-3476, 2002 Dec; Vol. 141 (6), pp. 839; PMID: 12461506 Database: MEDLINE with Full Text

Letter written about a parent who used the internet to research hyperglycemia and subsequently masked his daughter's blood glucose by fabricating a blood sugar diary.

Gaining vicarious self-esteem through associations with medical doctors: A self-enhancement explanation for factitious illness behavior.Citation Only Available Waxmonsky, Jeanette Audrey; Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 63(5-B), Nov, 2002. pp. 2612. [Dissertation] Database: PsycINFO Full Text from ProQuest

Dissertation on Factitious disorder. May offer insights on motivation, but not directly related to internet communications.

{Munchausen syndrome mimicking Meniere's disease}Citation Only Available Syndrome de Munchausen mimant une maladie de Menière. (fre; includes abstract) By Kos MI, Guyot JP, Annales D'oto-Laryngologie Et De Chirurgie Cervico Faciale: Bulletin De La Société D'oto-Laryngologie Des Hôpitaux De Paris [Ann Otolaryngol Chir Cervicofac], ISSN: 0003-438X, 2002; Vol. 119 (3), pp. 159-63; PMID: 12218870 Database: MEDLINE with Full Text

In French.

Munchausen by Internet: detecting factitious illness and crisis on the Internet.Full Text Available (eng; includes abstract) By Feldman MD, Southern Medical Journal [South Med J], ISSN: 0038-4348, 2000 Jul; Vol. 93 (7), pp. 669-72; PMID: 10923952 Database: MEDLINE with Full Text HTML Full Text PDF Full Text

Patient pretenders weave tangled "Web" of deceit.Citation Only Available (eng) By Stephenson J, JAMA: The Journal Of The American Medical Association [JAMA], ISSN: 0098-7484, 1998 Oct 21; Vol. 280 (15), pp. 1297; PMID: 9794296 Database: MEDLINE with Full Text

Responses to unsolicited patient e-mail requests for medical advice on the World Wide Web.Citation Only Available (eng; includes abstract) By Eysenbach G, Diepgen TL, JAMA: The Journal Of The American Medical Association [JAMA], ISSN: 0098-7484, 1998 Oct 21; Vol. 280 (15), pp. 1333-5; PMID: 9794313 Database: MEDLINE with Full Text

Article discusses medical responses to potential patient emails asking about a condition they may have learned about online. Factitious disorder is not mentioned or alluded to in the article.

See also

• Literature and Medicine 16.1 (1997) 88-107, "A Whole Other Story": The Electronic Narrative of Illness Faith McLellan

Article describes an online community discussing Leukemia and the importance and dynamics of support groups. Article does not state that any members have fabricated their stories, but presents intriguing look at online support group dynamics, including personal investment in other members' lives.

• DEPRESSION AND ANXIETY 17:207–216 (2003)PROBLEMATIC INTERNET USE: PROPOSED CLASSIFICATION AND DIAGNOSTIC CRITERIA Nathan A. Shapira, M.D., Ph.D.,1n Mary C. Lessig, B.S.,1 Toby D. Goldsmith, M.D.,1 Steven T. Szabo, Ph.D.,2 Martin Lazoritz, M.D.,1 Mark S. Gold, M.D.,1and Dan J. Stein, M.D., Ph.D.,1,3

Article discusses internet addiction and compulsive behavior (gambling, buying, obsessive video gaming, other psychiatric illnesses and paraphilias) mentioning the possibility that compulsive internet use may warrant discussion as to whether it is its own illness or related to previously identified disorders. Munchausen by Internet is mentioned among several types of problematic behaviors.

• Online Empathy for Mood Disorders Patients Turn to Internet Support Groups Lynne Lamberg JAMA. 2003;289:3073-3077.

Article describes the nature and usefulness of internet support groups (ISG) for people with mood disorders. Primarily the article is concerned with people using ISGs for networking and perhaps in lieu of interpersonal support groups and real-life doctor interaction. It is also concerned with the accuracy of information disseminated by amateurs involved in ISGs. It briefly mentions Munchausen by Internet:

Faking It Is Easy Online / While many approach Internet encounters in a spirit of honesty, the anonymity of the medium can provide easy cover for individuals with factitious disorders. Some desire attention or sympathy, while others seek revenge or control over others. Marc Feldman, MD, a psychiatrist practicing in Birmingham, Ala, calls this phenomenon "Münchausen by Internet," or MBI. Most of the 35 cases he has documented involve medical illnesses, with bogus reports of life-threatening crises, calls to 911, surgeries and other procedures, and miraculous recoveries. Individuals with MBI betray themselves by caricaturing genuine illness, often citing textbook lists of symptoms that may include depression as one of many. One man joined an ISG for individuals with bipolar disorder, claiming to suffer profound depression. When group members suspected his ruse and challenged him, he threatened to kill himself. He later signed on, professing to be the allegedly dead man's son, and blamed the group for pushing his father to the edge. Some members of the group were so distressed, Feldman said in an interview, they actually became suicidal themselves. "Outing" of a pretender may make some members of an ISG feel hurt and betrayed, and leave the group in disgust. At minimum, such deceptions divert the ISG's attention from its primary focus. Individuals with MBI, when detected, may castigate the group, saying, "If you had been more supportive, I wouldn't have had to make up stories." Unfortunately, says Feldman, individuals with MBI can gain new audiences merely by clicking from one ISG to another (South Med J. 2000;93:669-672).—L.L.

Information about suicidal members of ISGs who have encountered MbI may be worth adding to article, with blaming those who believed them.

Characteristics

This section also deals with the history of the condition. Would be useful to move the history aspect to its own section.Doc James (talk · contribs · email) 12:23, 4 May 2010 (UTC)

On shifting Notable cases: I don't see the reason for this and MEDMOS doesn't really address this. Although this article falls under the MEDMOS umbrella and I think editors should stick as close as possible to the formatting suggested by MEDMOS, because this issue straddles medical and social/Internet, I think the discussion of how Munchausen by Internet affects the social aspects of the Internet should come last, after the discussion of the psychiatric implications of this pattern. That is why I reverted the shift for this section. Furthermore, when Notable cases was higher above, it referenced some issues that are re-referenced again lower in the article. With the shift, these references don't make any sense. Doc James, can you justify this move, please or revert?

On a separate history section: There's not really much of a history to discuss. It was only identified in the late 1990s. There are only two sentences that could be considered the history of the pattern and that's not really worth an entire section unto itself. --Moni3 (talk) 18:55, 4 May 2010 (UTC)

I guess I defined discovery as history well notabal cases and impact on online communities would belong under society and culture. BTW any information on how commonly this occurs? Ie Epidemiology?--Doc James (talk · contribs · email) 19:05, 4 May 2010 (UTC)

I have not found information on how common this pattern occurs. Dr. Feldman has stated that he has attempted to interview people who have perpetrated ruses in online forums but has been unable to develop a significant correspondence with anyone so far. As such, no one has been diagnosed with Munchausen by Internet. It is Feldman's observations as an expert in factitious disorder that is the source of most of the material regarding the pattern.

The Notable cases section serves as a set of examples. It was previously located under the Characteristics section, which is logical to me: Concept→definition→examples→broader discussion of implications of the concept. This is a logical progression to introduce the reader to the issues in the article. --Moni3 (talk) 19:13, 4 May 2010 (UTC)

There are a couple more sources that discuss this condition at lenght that can be found by pubmed such as [1], [2] and PMID 18608864 . This article is a little limited in scope and I guess that is from due to the fact that it is a newly coined condition. If you turn the discover section into a section on history than combine the rest under society and culture along with notable cases it will better fit WP:MEDMOS Doc James (talk · contribs · email) 19:24, 4 May 2010 (UTC)

The section above this one lists several articles I read that were related to the concepts of MBI. You'll find the 1st and 3rd of you suggestions above, neither of which are appropriate for the reasons stated in green. The Legal Aspects article by Feldman is already cited in the Wiki article.

I agree the article is limited in scope. It's not its own condition, but related to another with implications for online venues that don't really affect Factitious disorder or Factitious disorder by proxy. So it deserves its own article space, but it cannot really be given the same amount of attention that both Factitious and Factitious by proxy are. So the article cannot really fit perfectly in MEDMOS, but it can model as much as possible the guidelines for medical articles. I can't see your vision to restructure the article. I'm not saying it's not worth it, but I just don't see it. Can you perhaps model what you're thinking here on the talk page so I can better understand what you're trying to accomplish? Thanks. --Moni3 (talk) 19:35, 4 May 2010 (UTC)

Sure will look more closely in a bit. Doc James (talk · contribs · email) 19:40, 4 May 2010 (UTC)

Okay Moni I understand your justification and will leave it as is. Cheers.Doc James (talk · contribs · email) 21:50, 5 May 2010 (UTC)

Name capitalisation

Current name is "Münchausen by Internet", were this not already a good quality article, I would have expected this to follow WP:LOWERCASE and have been tweaked to "Münchausen by internet" for the internet is not a proper name ? David Ruben ^Talk 04:08, 8 May 2010 (UTC)

This came up in the GA review: According to an entry in the Oxford English Dictionary: K. HAFNER & M. LYON Where Wizards stay up Late (1998) viii. 244 Roughly speaking, an ‘internet’ is private and the ‘Internet’ is public. The distinction didn't really matter until the mid-1980s when route vendors began to sell equipment to construct private internets. But the distinction quickly blurred as the private internets built gateways to the public Internet. --Moni3 (talk) 12:27, 8 May 2010 (UTC)

Spelling

A common English spelling of Münchhausen is Munchausen, but spelling Münchhausen as Münchausen makes it just wrong in two languages. —Preceding unsigned comment added by 91.22.190.207 (talk) 15:41, 28 July 2010 (UTC)

Explanation please?

In this edit, with an edit summary that asserted, in part, "hid image for BLP and FUR concerns", another contributor excised an image I had added to this article.

I request an explanation of this WP:BLP concern. BLP is supposed to do various things, including protecting ordinary individuals who are basically private persons. If I am not mistaken, different standards apply to individuals you actively seek public attention. As someone who actively solicited public attention, who appeared at benefit concerts she arranged to have organized on her behalf, and who actively sought donations from her 4,000 facebook followers, I don't think Ashley Kirilow should be considered an essentially private person.

I just checked BLP, the closest clauses I could find that would prohibit the use of Kirilow's image were:

When the name of a private individual has not been widely disseminated or has been intentionally concealed... The presumption in favor of privacy is strong in the case of family members of articles' subjects and other loosely involved, otherwise low-profile persons.

These clauses, IMO, just do not apply. Kirilow's story has received world-wide coverage -- I consider this "widely disseminated". Similarly, I think this means she should not be characterized as a "low-profile" person.

Similarly I request an explanation of the WP:FUR concern. Geo Swan (talk) 22:53, 12 September 2010 (UTC)

Actually, a greater question is why she is included in the article at all. There's no mental illness diagnosis for Kirilow, and she's reportedly admitted she did this for the money, not for the sympathy, so this case doesn't really fall into this category. Risker (talk) 23:42, 12 September 2010 (UTC)

• As I note below, Feldman is the therapist who first described this version of Munchausen Syndrome. You don't know why she did this. I don't know why she did this. However as someone her family describes as totally unreliable I wonder why you rely on her claim to have lied solely for money. Kirilow is not a therapist. Feldman is. Even if he is speculating, even if he has not personally examined her, as a notable expert, as the guy who "wrote the book" on this syndrome, why don't you regard his speculation as worthy of inclusion? Geo Swan (talk) 00:26, 13 September 2010 (UTC)

I totally agree. I did some research, and the only press article that connects Kirilow with Münchausen seems to be this: [3]. In the article it's totally clear that the diagnosis is made by a doctor who has never seen that person, and that it's entirely conjectural. I think I have removed all mentions of Kirilow. Hans Adler 00:05, 13 September 2010 (UTC)

• The article you cite was originally published in the Toronto Sun. To be fair, may I remind you that it was Feldman who first described Munchausen by internet? It seems to me that this adds greater weight to Feldman's informal speculation that you credit. To be fair, could we please refer to the whole Feldman quote? “Although there is clear evidence in the Kirilow case of malingering - lying about illness to get money – I would bet that the principal motive was an intangible one: to get attention, nurturance, care and concern that she felt unable to get in other ways.” Geo Swan (talk) 00:17, 13 September 2010 (UTC)
  • Joanne Richard (2010-08-08). "Accused cancer faker isn't alone". Toronto Sun. Retrieved 2010-08-18. mirror

It doesn't matter where the article was published first. The fact that Feldman first described this condition gives his claim that this is an example less weight, if anything. (There was a famous case of a British physician who destroyed many innocent families as an expert witness because he saw cases of "his" condition everywhere. I think in the end he got a prison sentence for that. I can look it up if you don't believe me.)

But the main problem is that Feldman uses the following words:

“Although there is clear evidence in the Kirilow case of malingering - lying about illness to get money – I would bet that the principal motive was an intangible one: to get attention, nurturance, care and concern that she felt unable to get in other ways.”

This makes it clear that it's pure conjecture, and implicitly it's also clear that he never formally diagnosed the person. We can't associate a BLP with a mental illness just because an expert has conjectured it. Apparently it wasn't even reported very widely. Hans Adler 00:29, 13 September 2010 (UTC)

• Ironically, this is actually a "local" story for me, which is why I am aware of the fraud element here; I was genuinely surprised to see this person mentioned in this article. Risker (talk) 00:35, 13 September 2010 (UTC)

Hans, the two well known cases in the UK are Roy Meadow and David Southall. Neither was charged with a criminal offence or spent time in prison. Meadow was originally brought before the GMC for serious professional misconduct and struck off but that was overturned on appeal as insufficiently serious. Southall was eventually struck off for serious professional misconduct. Fainites ^barleyscribs 16:04, 13 September 2010 (UTC)

Yes, I half remembered incomplete and possibly biased information that I had read years ago. The story wasn't as exciting as I remembered it, but information on the Crown Prosecution Service website still makes it clear that there was some severe overdiagnosing going on in the area and that they are now trying to keep the problem under control. But it's not really related to this article, and I don't think the information under discussion has a chance to of returning unless new sources emerge. Hans Adler 16:11, 13 September 2010 (UTC)

I agree! One of the problems with MbP (or FII as it is now called over here) is that people who were paediatricians were "diagnosing" supposed mental conditions. Actually FII is really a set of behaviours, to be ascertained by medical forensic analysis. Once you have the medical facts you can start looking for the reasons or causes of the behaviour but there's no one specific mental illness as such. However, current nosologies exclude rational reasons like fraud or other tangible gain. The articles make interesting reading though.Fainites ^barleyscribs 16:34, 13 September 2010 (UTC)

Notes for future edits and updates

• Sick note: Faking illness online, The Guardian, February 26, 2011.

• Watch Gawker and other sites for comments on the Reddit Ask Me Anything thread by Lucidending "51 Hours to Live" (March 6, 2011). (Note also corresponding jump to hits to this article the next day.)

• Oregon's Death with Dignity Act post stirs worldwide sympathy on reddit.com The Oregonian, March 7, 2011. --Moni3 (talk) 16:46, 12 March 2011 (UTC)

First sentence

"chat rooms, message boards, and Internet Relay Chat" - because IRCs aren't chat rooms?! --87.122.131.77 (talk) 14:34, 19 February 2015 (UTC)

Requested move 24 June 2015

The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: Move. Cúchullain ^t/c 12:40, 10 July 2015 (UTC)

---

• Münchausen by Internet → Munchausen by Internet
• Münchausen syndrome by proxy → Munchausen syndrome by proxy

– As an editor wrote above, the current spelling of these two articles is "wrong in two languages." It's either Munchausen (no umlaut, one "h") or Münchhausen (umlaut, two "h"s). The proposed titles satisfy WP:AT, as they are the WP:COMMONNAME according to sources, and are consistent with Munchausen syndrome - after which these articles are named - as well as Baron Munchausen, etc. --Relisted. George Ho (talk) 06:02, 1 July 2015 (UTC) Dohn joe (talk) 13:37, 24 June 2015 (UTC)

• Support per nom. Regards, Sovereign/^Sentinel 17:00, 24 June 2015 (UTC)

---

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

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Bold

I was bold and trimmed the article. It was very difficult to read, and still is due to the verbosity. I hope we can trim more to make it readable. Lets discuss if anyone thinks I was too bold. Lightburst (talk) 19:18, 21 July 2020 (UTC)