What Is Munchausen Syndrome? (2022)

What Is Munchausen Syndrome?

Munchausen syndrome is a mental disorder in which a person routinely acts as if they have a true physical or mental health issue even though they are really not sick. A person with this condition will deliberately create, complain of, or exaggerate symptoms of an illness that does not really exist.

The disorder has since been renamed and is now classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as "factitious disorder imposed on self."

Symptoms

People with factitious disorder imposed on self (FDIS) will deliberately cause, misrepresent, and/or exaggerate their symptoms (physical or psychological). They may suddenly leave a hospital and move to another area when it is discovered that they are not being truthful.

People with Munchausen syndrome can be extremely manipulative since the main symptom of this disorder requires deception and dishonesty.

The following are some examples of behavior you may see in somebody with FDIS:

  • Complaining of neurological symptoms (such as seizures, dizziness, or blacking out), the presence of which are often difficult to determine
  • Doing something to purposely injurethemselves in order to cause illness (for example, drinking a poisonous substance to have a violent stomach reaction)
  • Exaggeration of an actual injury that may lead to additional and unnecessary medical intervention
  • Falsifying medical records to specify an illness
  • Manipulating a laboratory test (for example, by adding blood to urine or ingesting a medication) to obtain a false abnormal result
  • Physically hurting themselves to cause an injury
  • Reporting being depressed and suicidal following an event (like a death of a child) even though there was no death and/or the person does not even have a child

Warning Signs

If you are concerned that someone you know may be affected by FDIS, there are some warning signs that you canlook out for. The main sign is that the individual seems to always be complaining about and/or exaggerating symptoms of an illness.

Additional warning signs can include:

  • Ambiguous symptoms that are not able to be controlled and become even more severe or change after beginning treatment
  • Complaints of new or more symptoms following negative test results
  • Extensive but inconsistent medical history
  • Extensive knowledge of hospitals and/or medical terminology (including textbook descriptions of illnesses)
  • History of obtaining treatment at several hospitals, clinics, and doctors' offices (possibly in different cities or zip codes)
  • Presence of symptoms only when the person is alone or not being observed
  • Problems with identity and self-esteem
  • Reluctance or unwillingness to allow medical professionals to meet with or talk to family, friends, or past medical providers
  • Willingness or eagerness to go to the hospital as well as undergo medical tests, operations, and procedures

Diagnosis

Diagnosing FDIS can be very hard because of all of the dishonesty associated with the disorder. Doctors must first rule out any possible physical and mental illnesses before considering a diagnosis of Munchausen syndrome.

Additionally, in order to be diagnosed with Munchausen syndrome/factitious disorder imposed on self, the following four criteria must be met:

  1. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception
  2. The individual presents himself or herself to others as ill, impaired, or injured
  3. The deceptive behavior is evident even in the absence of obvious external rewards
  4. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder

Difference Between Provisional and Differential Diagnoses

Causes

The exact cause of this disorder is not known. Due to the deception surrounding Munchausen syndrome, it is also not known exactly how many people are affected by it (but the number is likely very low). The onset of symptoms usually occurs in early adulthood, often after hospitalization for a medical condition. Unfortunately, this is a complex and poorly understood condition.

Childhood Abuse or Neglect

One theory of what causes this mental disorder is a history of abuse, neglect, or abandonment as a child. A person may have unresolved parental issues because of this trauma. These issues may, in turn, cause the individual to fake being sick.

People may do this because they:

(Video) Munchausen's syndrome | NHS

  • Need to feel important and be the center of attention
  • Have a need to punish themselves by making themselves sick (because they feel unworthy)
  • Need to pass responsibility for their welfare and care on to other people

Effects of Childhood Trauma

Childhood Illness and Hospitalization

Another theory points to a history of frequent or prolonged illnesses that required hospitalization (especially if this took place during childhood or adolescence). The rationale behind this theory is that people with Munchausen syndrome may associate their childhood memories with a sense of being taken care of. After becoming adults, they may try to achieve the same feelings of comfort and reassurance by pretending to be ill.

Personality Disorders

There may also be a link between personality and factitious disorder imposed on self. This is because personality disorders are common in people with Munchausen syndrome. This disorder may stem from the person’s inner need to be seen as sick or disabled. It could also be due to the person having an insecure sense of their own identity.

People affected by this disorder are willing to go through extreme measures, such as undergoing painful or risky tests or operations in an attempt to gain the sympathy and special attention given to people who are truly sick. So pretending to be sick allows them to assume an identity that elicits support and acceptance from others. Admission to the hospital can also provide a clearly defined place in a social network.

Types

Both Munchausen syndrome and Munchausen syndrome by proxy are categorized as factitious disorders. With Munchausen syndrome, the person presents themselves to others as being sick, whereas with Munchausen syndrome by proxy, the person presents another individual as being ill or injured.

This other individual, who can be a child, another adult, or pet, is considered to be a victim. A person affected by Munchausen syndrome by proxy may also be guilty of criminal behavior if their actions consist of abuse and/or maltreatment.

Treatment

Although people with Munchausen syndrome may actively obtain treatment for the numerous disorders they create, they typically do not want to admit to and seek treatment for the actual syndrome.

People affected with factitious disorder imposed on self deny they are faking or causing their own symptoms, so obtaining treatment tends to be dependent on somebody else suspecting that the person has this disorder, persuading the individual to receive treatment, and encouraging the person to stick to treatment goals.

Psychotherapy

The main treatment goal for Munchausen syndrome is to change the person's behavior and lessen the misuse/overuse of medical resources. Treatment usually consists of psychotherapy (mental health counseling).

During treatment sessions, the therapist may try to challenge and assist in changing the thinking and behavior of the person (this is known as cognitive behavioral therapy). Therapy sessions may also try to uncover and address any underlying psychological issues that may be causing the person's behavior.

During treatment, it is more realistic to have the person work toward managing the syndrome as opposed to trying to cure it. A therapist may try to encourage the person to avoid dangerous medical procedures as well as unnecessary hospital admissions.

In addition to individual therapy, treatment may also include family therapy. Teaching family members how to properly respond to a person diagnosed with Munchausen syndrome can be helpful.

The therapist can teach family members not to reward or reinforce the behavior of the person with the disorder. This may make lower the person's need to appear sick since they may no longer be receiving the attention they are seeking.

(Video) Raw interview: What is Munchausen syndrome by proxy?

Medication

Medication is typically not used in the treatment of FDIS. If the person is also experiencing anxiety or depression, however, a doctor may prescribe medication, including selective serotonin reuptake inhibitors(SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs),benzodiazepines, andtricyclic antidepressants(TCAs).

If this is the case, it is important that the person is closely monitored because of the higher likelihood of using these medications to purposely hurt themselves.

A Word From Verywell

If someone you love is living with FDIS, it's important to seek help. Munchausen syndrome is associated with severe emotional difficulties, including an increased risk for substance use and suicide attempts.

People with FDIS are also at risk for health problems or death because of their purposeful actions of trying to hurt themselves. They can suffer additional harm from complications associated with multiple tests, procedures, and treatments.

If you or a loved one are struggling with Munchausen syndrome or self-harm, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

7 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Caselli I, Poloni N, Ielmini M, Diurni M, Callegari C. Epidemiology and evolution of the diagnostic classification of factitious disorders inDSM-5.Psychol Res Behav Manag. 2017;10:387–394. doi:10.2147/PRBM.S153377

  2. Cleveland Clinic. An Overview of Factitious Disorders.

  3. Yates GP, Feldman MD. Factitious disorder: a systematic review of 455 cases in the professional literature. Gen Hosp Psychiatry. 2016;41:20-28. doi:10.1016/j.genhosppsych.2016.05.002

  4. Sousa Filho D, Kanomata EY, Feldman RJ, Maluf Neto A. Munchausen syndrome and Munchausen syndrome by proxy: A narrative review. Einstein (Sao Paulo). 2017;15(4):516-521.

  5. Burnel A. Recognition and management of factitious disorder. Presscriber. 2015;26(21):37-39. doi:10.1002/psb.1411

  6. Faedda N, Baglioni V, Natalucci G, et al. Don't judge a book by its cover: Factitious disorder imposed on children-report on 2 cases.Front Pediatr. 2018;6:110. doi:10.3389/fped.2018.00110

  7. Mousailidis G, Lazzari C, Bhan‐Kotwal S, Papanna B, Shoka A. Factitious disorder: A case report and literature review of treatment. Prog Neurol Psychiatry. 2019;23(2): 14-18. doi:10.1002/pnp.533

Additional Reading

(Video) What is Munchausen syndrome by proxy?

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.

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(Video) The Psychology of Faking an Illness [Munchausen Syndrome]

FAQs

What is Munchausen's syndrome defined as? ›

Munchausen's syndrome is a rare psychological and behavioural condition in which somebody fabricates or induces symptoms of illness in themselves. Munchausen's syndrome is named after a German aristocrat, Baron Munchausen, who became famous for telling wild, unbelievable tales about his exploits and past.

What is Munchausen syndrome called now? ›

Factitious disorder imposed on another (previously called Munchausen syndrome by proxy) is when someone falsely claims that another person has physical or psychological signs or symptoms of illness, or causes injury or disease in another person with the intention of deceiving others.

What is Munchausen syndrome caused by? ›

What Causes Munchausen Syndrome by Proxy? The exact cause of MSP is not known, but researchers are looking at the roles of biological and psychological factors in its development. Some theories suggest that a history of abuse or neglect as a child, or the early loss of a parent may be factors in its development.

What is an example of Munchausen syndrome? ›

Munchausen syndrome (factitious disorder imposed on self) is when someone tries to get attention and sympathy by falsifying, inducing, and/or exaggerating an illness. They lie about symptoms, sabotage medical tests (like putting blood in their urine), or harm themselves to get the symptoms.

How do you prove someone has Munchausen? ›

The Warning Signs of Munchausen Syndrome by Proxy

a history of repeated injuries, illnesses, or hospitalizations. symptoms that don't quite fit any disease. symptoms that don't match test results. symptoms that seem to improve under medical care but get worse at home.

Why is it no longer called Munchausen? ›

This name referred to a figure named Baron Munchausen who was known for exaggerated stories. The change from Munchausen syndrome by proxy to factitious disorder imposed on another provides a more accurate description of a person's behavior. This new name is more specific.

What is it called when you diagnose yourself with everything? ›

Illness anxiety disorder, sometimes called hypochondriasis or health anxiety, is worrying excessively that you are or may become seriously ill.

What is the opposite of Munchausen? ›

Munchausen syndrome by proxy may be seen as opposite of medical neglect. Instead of the family's underproviding medical services, it overprovides them, sometimes by exaggerating symptoms or sometimes by falsifying symptoms and laboratory findings.

What's the difference between factitious disorder and Munchausen? ›

There are two kinds of factitious disorder: Factitious disorder imposed on self (FDIS): The person lies about their own health. Also called Munchausen syndrome. Factitious disorder imposed on another (FDIA): The person lies about someone else's health.

Why did Gypsys mom make her sick? ›

Experts believe Dee Dee had a mental illness known as Munchausen syndrome by proxy (also called factitious disorder imposed on another), which made her fabricate her daughter's ill health in order to receive attention and sympathy for taking care of a sick child.

What mental illness makes you act like a child? ›

The 'Peter Pan Syndrome' affects people who do not want or feel unable to grow up, people with the body of an adult but the mind of a child. The syndrome is not currently considered a psychopathology. However, an increasingly larger number of adults are presenting emotionally immature behaviors in Western society.

Does Munchausen run in families? ›

Munchausen syndrome is not genetic or hereditary, so if the disorder runs in a family it is not due to genes, but may more likely be due to the upbringing or the environment a child has experienced.

How do you say Munchausen syndrome by proxy? ›

How to Pronounce Munchausen - YouTube

What is it called when you hurt yourself for attention? ›

Factitious disorder imposed on self (FDIS) is a type of mental disorder in which a person will intentionally cause, create or exaggerate an injury or illness in his or herself.

Is Munchausen a crime? ›

Munchausen Syndrome by Proxy allegations are extremely serious. If charged with child abuse, a parent may lose custody of his or her child. If convicted, serious criminal penalties will follow, including long-term imprisonment and heavy fines.

What were Gypsy Roses conditions? ›

When Gypsy was a child, her mom Dee Dee told her that she suffered from leukemia and a host of other health issues. Gypsy revealed in a 20/20 interview that the only medical condition she actually has is a lazy eye.

How can you tell if someone is faking mental illness? ›

However, some indications of faking mental illness can include exaggerating any existing symptoms, making up medical or psychological histories, causing self-harm, tampering with medical tests, or malingering.

Can your mind trick you into feeling symptoms? ›

When physical symptoms are caused or made worse by your mental state, it's called psychosomatic. Many people believe that psychosomatic symptoms aren't real — but they are, in fact, very real symptoms that have a psychological cause, Jones says.

Is Munchausen syndrome a mental illness? ›

Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.

Can you convince yourself you have symptoms? ›

Hypochondria symptoms can vary, depending on factors such as stress, age, and whether the person is already an extreme worrier. Health anxiety can actually have its own symptoms because it's possible for the person to have stomachaches, dizziness, or pain as a result of their overwhelming anxiety.

Can a child have Munchausen syndrome? ›

Case reports of child and adolescent illness falsification has been described in the US and worldwide. In fact, many of the Munchausen syndrome by proxy mothers describe inducing illness in themselves in their teenage years.

What is the new name for Munchausen by proxy? ›

For example the child may have unnecessary treatment or tests, be made to believe they're ill, or have their education disrupted. FII used to be known as "Munchausen's syndrome by proxy" (not to be confused with Munchausen's syndrome, where a person pretends to be ill or causes illness or injury to themselves).

What is a common characteristic of parents with Munchausen syndrome by proxy? ›

Caregivers with Munchausen's syndrome by proxy create or exaggerate a child's symptoms in several ways. These include: Lying about a child's symptoms. Manipulating tests—for example, contaminating a urine sample with blood. Falsifying medical records.

Is attention seeking a mental illness? ›

Histrionic personality disorder (HPD) is a mental health condition marked by unstable emotions, a distorted self-image and an overwhelming desire to be noticed. People with HPD often behave dramatically or inappropriately to get attention.

What is the opposite of Munchausen syndrome? ›

Munchausen syndrome by proxy may be seen as opposite of medical neglect. Instead of the family's underproviding medical services, it overprovides them, sometimes by exaggerating symptoms or sometimes by falsifying symptoms and laboratory findings.

What mental illness makes you act like a child? ›

The 'Peter Pan Syndrome' affects people who do not want or feel unable to grow up, people with the body of an adult but the mind of a child. The syndrome is not currently considered a psychopathology. However, an increasingly larger number of adults are presenting emotionally immature behaviors in Western society.

What is it called when you self diagnose yourself with everything? ›

This not only leads to people self-diagnosing incorrectly, but it also leads to more anxiety than you had before you did the Google search. Psychologists call this “cyberchondria” for obsessing on investigating health symptoms on the Internet.

What were Gypsy Roses conditions? ›

When Gypsy was a child, her mom Dee Dee told her that she suffered from leukemia and a host of other health issues. Gypsy revealed in a 20/20 interview that the only medical condition she actually has is a lazy eye.

Does Munchausen run in families? ›

Munchausen syndrome is not genetic or hereditary, so if the disorder runs in a family it is not due to genes, but may more likely be due to the upbringing or the environment a child has experienced.

Do men get Munchausen? ›

18 In the past, men with Munchausen syndrome have been considered a danger to themselves but not to others. There was nothing to suggest that the fathers reported in this paper had harmed children outside their family, but we now have to accept that such men may be a danger to their own children.

How can you tell if someone is attention-seeking? ›

What it may look like
  1. fishing for compliments by pointing out achievements and seeking validation.
  2. being controversial to provoke a reaction.
  3. exaggerating and embellishing stories to gain praise or sympathy.
  4. pretending to be unable to do something so someone will teach, help, or watch the attempt to do it.
28 Feb 2020

What do you say when someone wants attention? ›

Respond using short statements like "that's nice" or "okay" instead. That said, if the person has a genuinely good idea or a fun story, don't be afraid to show your interest. Everyone needs genuine attention now and then. If you're actually interested in their hobbies or stories, you might enjoy the conversation.

Why do I crave attention from one person? ›

Risk factors leading to attention seeking behavior include loneliness, jealousy, low self-esteem, narcissism and self-pity. A desire for validation is theorised as a motivation for attention seeking behavior.

What's the difference between factitious disorder and Munchausen? ›

There are two kinds of factitious disorder: Factitious disorder imposed on self (FDIS): The person lies about their own health. Also called Munchausen syndrome. Factitious disorder imposed on another (FDIA): The person lies about someone else's health.

How can you tell if someone is faking mental illness? ›

However, some indications of faking mental illness can include exaggerating any existing symptoms, making up medical or psychological histories, causing self-harm, tampering with medical tests, or malingering.

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