Munchausen syndrome is a condition in which a person intentionally fakes, simulates, worsens, or self-induces an injury or illness for the main purpose of being treated like a medical patient. Munchausen syndrome is named after a German military man, Baron von Munchausen, who traveled around telling fantastic tales about his imaginary exploits. In 1951, Richard Asher applied the term to people traveling from hospital to hospital, fabricating various illnesses.

The term Munchausen syndrome is often used interchangeably with factitious disorder. Factitious disorder refers to any illness that is intentionally produced for the main purpose of assuming the sick role, although that purpose is unknown to the "sick" person. Munchausen syndrome most appropriately describes persons who have a chronic variant of a factitious disorder with mostly physical signs and symptoms, although there are reports in literature regarding psychological Munchausen syndrome, meaning that the simulated symptoms are psychiatric in nature.

Persons with Munchausen syndrome intentionally cause signs and symptoms of an illness or injury by inflicting medical harm to their body, often to the point of having to be hospitalized. These persons are sometimes eager to undergo invasive medical interventions. They are also known to move from doctor to doctor, hospital to hospital, or town to town to find a new audience once they have exhausted the workup and treatment options available in a given medical setting. Persons with Munchausen syndrome may also make false claims about their accomplishments, credentials, relations to famous persons, etc.

A related condition, called Munchausen by proxy syndrome, refers to a caregiver who fakes symptoms by causing injury to someone else, often a child, and then wants to be with that person in a hospital or similar medical setting.

The causes of Munchausen syndrome are unknown. Some experts suggest that it is a defense mechanism against sexual and aggressive impulses. Others believe it may be a form of self-punishment. Determining an exact cause is difficult because persons with Munchausen syndrome are not open and honest about their condition, making research on them nearly impossible.

Individuals with Munchausen syndrome intentionally produce or exaggerate symptoms. They may lie about or fake symptoms, self-induce injury to cause symptoms, or alter the results of tests by contaminating samples such as a urine sample. Signs and symptoms of Munchausen syndrome may include the following:

Exams and Tests

Depending on the symptoms, almost any laboratory test can be used. Test results that are inconsistent or atypical of the claimed illness may be an indication of Munchausen syndrome.

Imaging studies (such as x-rays or scans) may be helpful in diagnosing Munchausen syndrome. The claimed medical problem, such as tumors, can be easily viewed.

Medical Treatment

Initially, the medical care of persons with Munchausen syndrome is aimed at relieving the claimed symptoms and any injury made by the person to induce the symptoms. Treating people who have Munchausen syndrome is difficult because they are often unwilling to admit they have it. The treating doctor must be very judicious with invasive diagnostic tests or surgeries, yet try not to miss serious medical conditions.

Medications can be useful if conditions exist along with the Munchausen syndrome. Serotonin reuptake inhibitors have proved helpful in persons with Munchausen syndrome who have comorbid depression, and, at least theoretically, low-dose antipsychotics can help those with coexisting borderline personality disorder.

Persons with Munchausen syndrome can induce or develop authentic illnesses requiring surgery, but further surgical procedures should be treated with great caution.

Psychotherapy of various types (strategic, psychodynamic, cognitive) has been reported anecdotally to be of benefit in selected cases.

Many persons with Munchausen syndrome experience long-term medical complications from illnesses they have induced or from the mechanisms used to treat them.

Prevention

There is no known way to prevent Munchausen syndrome.

Persons with Munchausen syndrome are rarely treated successfully. They are reluctant to seek treatment for the psychological problem and are generally unwilling to undergo psychiatric treatment.

The self-inflicted illnesses and injuries of persons with Munchausen syndrome can cause serious illness. These individuals often undergo several unnecessary surgeries throughout their lifetime.