Munchausen Syndrome - Diagnosis

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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.

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