Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Munchausen syndrome is a mental disorder that is characterized by the
sufferer causing or pretending to have physical or psychological symptoms in his
or herself. It is thought to be motivated only by a desire to be seen as ill
rather than by avoiding responsibility, financial gain, improving his or her
physical condition, or some other benefit, as is true in malingering. Research
outcomes differ in terms of identifying groups that are susceptible to
developing the disorder. Some statistics indicate that women with health
training may be more vulnerable to developing Munchausen syndrome, particularly
when it presents with physical symptoms. However,
it is thought by other investigators that men and women experience Munchausen
syndrome in equal frequency. Still other studies describe middle-aged men who
are unmarried and estranged from their families as being the most susceptible to
developing this illness. While the disorder
may occur at any age, it seems to most often develop in late adolescence or
early adulthood and is either preceded by or coexists with Munchausen syndrome
by proxy. Munchausen syndrome is also
referred to as factitious disorder.
It is estimated that Munchausen syndrome occurs in 0.5%-2% of the United
States population. How common it is can be significantly higher in certain
subpopulations. For example, up to 9% of cases of fever of unknown origin are
the result of this disorder. More than 4% of people who were previously
diagnosed as having psychosis were found to have Munchausen syndrome.
Even before it was given its current name, this illness has been described
since at least biblical times. For example, sufferers of this attention-seeking
syndrome during the Middle Ages have been known to scrape off their skin and put leeches in their own
mouths in order to induce bleeding. This disorder was named for
Baron Karl Friedrich von Munchausen. Baron von Munchausen lived from 1720 to
1797, was born in Germany, joined the Russian military, and was known to tell
fantastic tales about the battles he participated in against the Ottoman Turks.
For example, he apparently told stories about riding cannonballs and traveling
to the moon.
In contrast to Munchausen syndrome, Munchausen syndrome by proxy (MSBP) is a
fabrication of illness by a third person that allows the third person, usually a
caretaker, to assume the sick role. The caretaker usually involved in the
development of MSBP is the victim's mother. Although both
Munchausen syndrome and somatoform disorders can be characterized by physical
complaints, Munchausen syndrome is different in that the complaints are
consciously invented or caused by the sufferer him or herself. For example, in
somatization disorder, conversion disorder, and hypochondria, the individual is
convinced that they really suffer from physical symptoms, have a deficit in
movement or sensory function, or are seriously ill, respectively.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with borderline personality disorder (BPD) suffer from a disorder of emotion regulation.
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
About 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Mental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy and medication.
Munchausen syndrome by proxy (MSBP) is a mental illness (factitious disorder) in which a caregiver secretly abuses a child by faking symptoms in the child. Symptoms present in the child include suffocation, bleeding, poisoning, and induced seizures. Treatment involves maintaining the safety of the child and typically incorporates psychotherapy and psychiatric medications for both the perpetrator and victim.
Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.
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