Factitious disorder - Diagnosing Munchausen's syndrome

Diagnosing Munchausen's syndrome can be challenging for medical professionals.

People with the condition are often very convincing and skilled at manipulating and exploiting a doctor's concern for their patient, and a doctor's natural interest in investigating unusual medical conditions.

Investigating claims

If a health professional suspects a person may have Munchausen's syndrome, they will usually make a detailed study of that person's health records to look for inconsistencies between their claimed and actual medical history. They may also attempt to talk to their family and friends to see if the person's claims about their past are true.

Health professionals can also run a number of clinical tests to check for evidence of self-inflicted illness or tampering of clinical tests. For example, the person's blood can be checked for traces of medication that they should not be taking but could explain their symptoms.

Doctors will also want to rule out other possible motivations for their behaviour, such as faking illness for financial gain or because they want access to strong painkillers.

A diagnosis of Munchausen's syndrome can usually be confidently made if:

• there is clear evidence of fabricating or inducing symptoms
• the person's prime motivation is to be seen as sick
• there is no other likely reason or explanation for their behaviour