Factitious disorder

People with Munchausen's syndrome often lie about symptoms that are difficult to disprove, such as having a severe headache or pretending to have a seizure

There are several warning signs someone may have Munchausen's syndrome.

Someone with the condition may:

  • make frequent visits to hospitals in different areas
  • claim to have a history of complex and serious medical conditions with little documentary evidence to support this (people often claim they have spent a long time out of the country)
  • have symptoms that do not correspond to test results
  • have symptoms that get worse for no apparent reason
  • have a very good medical knowledge
  • receive few or no hospital visitors (many people with Munchausen's syndrome adopt a solitary lifestyle and have little contact with friends or family)
  • be willing to undergo often painful or dangerous tests and procedures
  • report symptoms that are vague and inconsistent, or report a pattern of symptoms that are ‘textbook examples’ of certain conditions
  • tell highly unbelievable and often very elaborate stories about their past, such as claiming to be a decorated war hero or that their parents are fantastically rich and powerful

Patterns of behaviour

There are four main ways that people with Munchausen's syndrome fake or induce illnesses. These are outlined below.

  • Lying about symptoms. They often choose symptoms that are difficult to disprove, such as having a severe headache or pretending to have a seizure (fit) or to pass out.
  • Tampering with test results. For example, they may heat a thermometer to suggest a fever or add blood to a urine sample.
  • Self-infliction. They may cut or burn themselves, poison themselves with drugs or an overdose of medication, or eat food that has been contaminated with bacteria.
  • Aggravating pre-existing conditions. For example, they may rub dirt or dog faeces ('poo') into wounds to cause an infection or reopen previously healed wounds.

Munchausen's by internet

A relatively new condition has been labelled Munchausen's by internet. This is where a person joins an internet support group for people with a serious health condition, such as cystic fibrosis or leukaemia, and then claims to have the illness themselves.

While these actions may only be confined to the internet, they can have an incredibly destructive effect on support groups and online communities. People with genuine health conditions have reported feelings of betrayal and anger upon discovering they have been lied to.

One expert on Munchausen’s by internet has compiled a list of warning signs that indicate someone may be affected by the condition:

  • Their posts and messages seem to contain large chunks of information that appear to have been directly copied from health websites, such as NHS Choices.
  • They report experiencing symptoms that appear much more severe than most people would experience.
  • They claim to have near-fatal bouts of illness followed by a miraculous recovery.
  • They make fantastic claims which they later contradict or which others disprove at a later date. For example, they may claim to be attending a certain hospital that does not actually exist. 
  • They claim to have continual dramatic events in their life, such as loved ones dying or being the victim of a violent crime, particularly when other group members have become a focus of attention.
  • They feign an attitude of unconcern when they talk about serious problems, probably to attract attention and sympathy.
  • Other ‘people’ claim to post on their behalf, such as a parent or partner, but they use exactly the same pattern of writing.
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