Munchausen Syndrome (factitious disorder)
Unlike Munchausen by Proxy (formally termed Factitious Disorder Imposed on Another, or FDIA), most individuals with Munchausen Syndrome are a physical danger only to themselves. Although it is distinct from Malingering where the motive is external (such as obtaining opioids or disability payments), those with Munchausen Syndrome can consume millions of dollars in medical resources and cause extreme anguish to those who love them and genuinely believe that they are sick.
Warning Signs of Munchausen Syndrome
- Symptoms are not responsive to treatment and the individual even escalates, relapses, or comes up with new complaints in order to keep receiving care.
- The magnitude of symptoms consistently exceeds norms for the disease and/or the patient is clearly exaggerating symptoms.
- Some or all of the symptoms appear to be inflicted or made worse by the patient.
- There are remarkable numbers of tests, consultations, and treatment efforts that are mysteriously ineffective.
- The individual disputes test results that find no presence of a disease.
- The individual accurately predicts physical deteriorations.
- The individual “doctor shops,” or repeatedly moves care to another facility when a doctor determines there are no apparent medical issues.
- The individual presents inconsistent, selective, or misleading information about their own symptoms and health history.
- The individual refuses to allow their treatment team to speak to any other professionals about their care, including previous doctors.
- The individual has a long and ultimately inexplicable history of health problems such that it strains credulity to the breaking point.
- Previous health professionals have noted the possibility of deception.
- The individual does not follow treatment recommendations and is disruptive.
- The individual focuses on his or her self-perceived “victimization” by medical personnel and others.
- There is consistent evidence from laboratory or other tests that disproves information supplied by the individual.
- The individual has had exposure to a model of the ailment they are falsifying (e.g., a relative with a similar ailment).
- Even while pursuing medical or surgical assessments, the individual vigorously opposes psychiatric assessment and treatment.
- During interviews, the individual makes statements to strengthen his or her case that nevertheless contradict the records.
Q & A About Munchausen with The Cleveland Clinic
Dvora Meyers – Longreads/ The Disease of Deceit (2020)
Linda Marsa – Nautilus / Sick for Attention (2016)
Psychiatric Times/ Munchausen vs. Malingering (2009)
How Stuff Works / Podcast interview with MDF (2007)
New York Times feature on a Munchausen Patient in Recovery / Wendy Scott