Munchausen Syndrome

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    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.

What are Munchausen syndrome symptoms and signs?

The specific signs and symptoms of Munchausen syndrome can be extremely varied, from heart symptoms like fainting and chest pain, to ear problems seen by specialists in that area, to overtly psychiatric symptoms like hallucinations. The most common physical symptoms tend to include:

Although the specific symptoms that the individual complains of are nearly limitless, sufferers may have in common a pattern of seeking treatment at several care providers and hospitals, seem to provide inconsistent medical history, have symptoms that are exaggerated, vague, and/or inconsistent with test results, have an illogical course to their illness, usually worsening, an unwillingness to allow current health care professionals to talk to family members or previous care providers, be excessively pleased to be subjected to multiple tests and procedures, as well as seeming happy to receive a medical diagnosis and have an excessive desire to receive medications. People with this condition may also engage in self-injury, altering test results, and have predictable relapses. Interestingly, the symptoms of Munchausen syndrome are very similar in children and adolescents as they are in adults.

How do health professionals diagnose Munchausen syndrome?

As occurs with some psychiatric conditions, there is ongoing debate about how to best understand and diagnose Munchausen syndrome. The diagnosis, now referred to as factitious disorder as indicated by the widely accepted criteria set by the Diagnostic and Statistical Manual of Mental Disorders (DSM) requires that the sufferer exhibit the following:

  • Purposefully producing or pretending to have physical or mental-health signs or symptoms
  • Presenting oneself as being sick, hurt, or impaired
  • Engaging in the behaviors even when there are no obvious external motivators (like financial gain, avoiding legal problems, or improving physical well-being)

There is no specific definitive test, like an X-ray or a blood test, which can assess that a person has Munchausen syndrome. Therefore, practitioners perform a mental-health interview that looks for the presence of the symptoms previously described. People with this condition may exhibit signs like having extensive knowledge of medical terminology, and they may have multiple surgical scars despite having little objective evidence of a diagnosable physical condition. As with any mental-health evaluation, the professional will work toward ruling out other mental conditions and ensuring that the individual does not have a primary medical illness or from medical issues that may cause emotional problems. He or she will often inquire about when the person has most recently had a physical examination, comprehensive blood work, and any other medical tests that a professional deems necessary to ensure that the person does not have a true medical condition rather than or in addition to potentially feigning or causing symptoms. It is also important for the practitioner to review any available medical records and talking to other people who are in the person's life (like current or previous treating professionals, the spouse, or other family members) in order to explore the possibility that there is a pattern of the individual lying and/or faking symptoms in the past.

Medically Reviewed by a Doctor on 12/14/2015

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