Factitious disorder (Munchausen's syndrome)

Factitious disorder
(Munchausen's syndrome)

Definition

Epidemiology

Pathophysiology

Clinical
presentation

Diagnosis

Management

Psychological disorder of
intentional production of physical or
psychological signs and symptoms

Rare

Maladaptive coping
Disrupted illness behaviour and sick role
No external incentive (unlike malingering)

Trauma history
Abuse, neglect, medical problems,
medical mismanagement

Psychological
Type of PD

Physical
Pain
Pyrexia
Dermatoses
Diarrhoea
Infection
Intoxication

By proxy
Parent to child

Psychological
Pseudo-seizures
Psychosis, mania

Examination
Discrepancies between findings

Investigations
Mostly nil findings

History
Inconsistent, changing

Initial ABCDE

Definitive
Explanation and support
Manage comorbid problems