Factitious disorder

Munchausen's syndrome is a psychological and behavioural condition where someone pretends to be ill or induces symptoms of illness in themselves.

It is also sometimes known as factitious disorder.

People with the condition intentionally produce or pretend to have physical or psychological symptoms of illness.

Their main intention is to assume the "sick role" to have people care for them and be the centre of attention.

Any practical benefit for them in pretending to be sick – for example, claiming incapacity benefit – is not the reason for their behaviour.

Munchausen's syndrome is named after a German aristocrat, Baron Munchausen, who became famous for telling wild, unbelievable tales about his exploits.

Types of behaviour

People with Munchausen's syndrome can show different types of behaviour, including:

• pretending to have psychological symptoms – for example, claiming to hear voices or claiming to see things that are not really there
• pretending to have physical symptoms – for example, claiming to have chest pain or a stomach ache
• actively trying to get ill – such as deliberately infecting a wound by rubbing dirt into it

Some people with Munchausen's syndrome may spend years travelling from hospital to hospital feigning a wide range of illnesses. When it is discovered they are lying, they may suddenly leave hospital and move to another area.

People with Munchausen's syndrome can be very manipulative and, in the most serious cases, may undergo painful and sometimes life-threatening surgery, even though they know it is unnecessary.

Read more about the symptoms of Munchausen's syndrome.

What causes Munchausen's syndrome?

Munchausen's syndrome is a complex and poorly understood condition. It is still unclear why people with the condition behave in the way they do.

Some experts have argued that Munchausen's syndrome is a type of personality disorder.

Personality disorders are a type of mental health condition where an individual has a distorted pattern of thoughts and beliefs about themselves and others.

This leads them to behave in ways most people would regard as disturbed and abnormal.

Another theory is that the condition may be the result of parental neglect and abandonment, where only real or imagined illness gives them feelings of care.

Read more about the possible causes of Munchausen's syndrome.

Treatment

Treating Munchausen's syndrome can be challenging, as most people with the condition refuse to admit they are faking illness.

For those who do admit their behaviour is abnormal, talking therapies such as cognitive behavioural therapy can sometimes be effective.

Read more about the treatment of Munchausen's syndrome.

Who is affected?

From the available case studies, there appear to be two relatively distinct groups of people affected by Munchausen's syndrome:

• women aged 20 to 40 years old, who often have a background in healthcare, such as working as a nurse or a medical technician
• unmarried white men who are 30 to 50 years old

It is unclear why this is the case. It is also not known exactly how common Munchausen's syndrome is.

Some experts believe it is underdiagnosed because many people with the condition succeed in deceiving medical staff. It is also possible cases may be overdiagnosed as the same person could use different identities.

A large study carried out in a Canadian hospital estimated that out of 1,300 patients, there were 10 who were faking symptoms of illness.