I am a psychiatrist, author, and expert consultant. MUNCHAUSEN SYNDROME is the most severe and chronic form of my area of specialty, FACTITIOUS DISORDER. Munchausen syndrome, factitious disorder, and the other phenomena described here are well-recognized among psychiatrists, but they have not received the attention—or advocacy among consumers, families, and professionals—that have greeted more common ailments such as depression. However, factitious disorder can be every bit as disabling, and further education is vital.
People with factitious disorder and Munchausen syndrome feign, exaggerate, or actually self-induce illnesses. Their aim? To assume the status of “patient,” and thereby to win attention, nurturance, and lenience from professionals or nonprofessionals that they feel unable to obtain in any other way. Unlike individuals who engage in MALINGERING, people with factitious disorder and Munchausen syndrome are not primarily seeking external gains such as disability payments or narcotic drugs—though they may receive them nonetheless. In some cases, the fabrication or induction of illness is an expression of jealousy, rage, or the desire to control others.
In MUNCHAUSEN BY PROXY (MBP), increasingly known as FACTITIOUS DISORDER IMPOSED ON ANOTHER (FDIOA), or MEDICAL CHILD ABUSE (MCA), an individual falsifies or induces illness in another person to accrue emotional satisfaction—but this time vicariously. This is a form of maltreatment (abuse and/or neglect) and FDIOA itself is now classified as a mental disorder. Children are the usual victims and the mother is the usual perpetrator. Factitious disorder, whether imposed on self or another, can take place primarily via the Internet—typically through the manipulation of other people participating through social media. This variation is called MUNCHAUSEN BY INTERNET or MUNCHAUSEN BY PROXY BY INTERNET.
What do patients with factitious disorder and the rest of the phenomena on this site do? They deliberately mislead others into thinking they (or their children) have serious medical or psychological problems, often resulting in extraordinary numbers of medication trials, diagnostic tests, hospitalizations, and even surgery . . . that they know are not really needed. In short, factitious disorder, Munchausen syndrome, malingering, and Munchausen by proxy involve medical deception, or “disease forgery.”
- They may falsely report illness—e.g., by stating that they have terminal cancer or ADHD.
- They may feign illness—e.g., by faking a seizure or acting as if they have multiple personalities.
- They may falsify lab results—e.g., by adding blood or protein to a urine specimen.
- They may exaggerate a medical problem—e.g., by claiming occasional mild back pain is crippling.
- They may aggravate an existing ailment—e.g., by manipulating a wound so it doesn’t heal.
- They may induce an actual illness—e.g., by injecting themselves or their child with bacteria to cause a raging infection.
- They may “dissimulate”—e.g., by initially avoiding treatment so that a minor medical problem becomes serious.
In variations of the root problem, some seek the HERO or VICTIM role, rather than the SICK role. The good news is that knowledge about factitious disorder and the other phenomena has been increasing exponentially. The level of interest is growing, and the first, early version of this website (launched in 1996) received almost one million visits.
The term “Munchausen syndrome” was derived from the storybook character created by Rudolph Erich Raspe. In turn, the character was based on a real 18th century Prussian cavalry officer, Karl Friedrich Hieronymus Freiherr (Baron) von Munchhausen (1720-1797).
The pages in this website contain annotated links to further information about factitious disorder, Munchausen syndrome, malingering, Munchausen by proxy, and Munchausen by Internet/Munchausen by Proxy by Internet. I hope you find them helpful.
I can vouch only for the material in the links that I have personally written. I appreciate hearing about individuals’ experiences with the problems discussed on this site. Please note further that any health-related comments I might offer on this site or in emails are in no way a substitute for personal consultation with a physician or other professional. No doctor-patient relationship is implied or created.