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Munchausen syndrome
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Munchausen syndrome

Contributors: Michael W. Winter MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Munchausen syndrome, also known as factitious disorder, is a psychiatric condition characterized by the self-infliction or misrepresentation of symptoms without an apparent gain or motivation to the affected individual. Clinical presentation can vary widely as patients can appear as injured or ill from any number of diseases, but commonly these patients are high utilizers of the health care system who have symptoms that are not well explained by a known medical condition.

Patients with Munchausen syndrome may have a profound understanding of hospitals, health care systems, and medical language. Reported symptoms are typically severe with vague details about the historical details of their illness or injury.

Many patients will improve during hospital observation but worsen after discharge. Pathological lying and splitting contact between health care providers are common in patients with Munchausen syndrome.

Related topics: facticial dermatitis, factitial panniculitis, factitial ulcer, malingering, Munchausen syndrome by proxy, skin popping substance abuse

Codes

ICD10CM:
F68.10 – Factitious disorder imposed on self, unspecified

SNOMEDCT:
21586000 – Munchausen's syndrome

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Malingering – Conscious production of symptoms for recognized gain (as opposed to unrecognized gain by the patient in factitious disorder).
  • Munchausen syndrome by proxy
  • Somatic symptom disorder – Excessive distressing concern about symptoms.
  • Delusional disorder – Belief in an underlying physical illness reaches delusional intensity.
  • Conversion disorder – Unconscious production of symptoms (as opposed to conscious production in factitious disorder).
  • Illness anxiety disorder
The differential diagnosis is broad, but consider disorders with intermittent signs and symptoms, especially rare or uncommon ones. Possibilities include:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:07/01/2020
Last Updated:02/04/2021
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Munchausen syndrome
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Munchausen syndrome : Abdominal pain, Chest pain, Diarrhea, Vomiting, Hematuria, Hypoglycemia, Recurring episodes or relapses, Skin ulcer
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