Munchausen Syndrome

Medically Reviewed by Zilpah Sheikh, MD on November 05, 2024
Written by WebMD Editorial Contributors
7 min read

Munchausen syndrome is a factitious disorder, a mental health disorder in which a person repeatedly and deliberately acts as if they have a physical or mental illness when they are not really sick. It is considered a mental illness because it is associated with severe emotional difficulties.

Munchausen syndrome is named for Baron von Munchausen, an 18th-century German officer who was known for embellishing the stories of his life and experiences. It is the most severe type of factitious disorder. Most of the symptoms in people with Munchausen syndrome are related to physical illness — symptoms such as chest pain, stomach problems, or fever — rather than those of a mental disorder.

NOTE: Although Munchausen syndrome usually refers to a factitious disorder with mostly physical symptoms, the term is sometimes used to refer to factitious disorders in general. In this article, Munchausen syndrome refers to the type of factitious disorder with mostly physical symptoms.

Munchausen syndrome by proxy

This is the term used when someone (usually a parent or caregiver) acts as if the person in their care is sick when they're not. It's also known as a factitious disorder imposed on another (FDIA) because the person lies about the mental or physical health of another person. Typically the person they present as ill is a child younger than 6 or an elderly or disabled adult. Sometimes, these caregivers even introduce illnesses in those under their care. These actions are to gain sympathy and attention from others.

Munchausen syndrome by internet

This happens when healthy people present themself as ill in a virtual realm such as an online support group. This version of Munchausen syndrome was first identified in the early 2000s when illness support groups and other communities were recreated online. People falsely present themselves as sick or the "heroic" caregiver of a sick person. These falsehoods can leave truly ill members of these groups with a sense of betrayal and anger when they discover the untrue claims.

Munchausen syndrome vs. malingering

Malingering is when someone benefits financially or otherwise from pretending to be sick. For example, they may falsely claim illness to get an insurance payout, avoid military service, or get out of work. Like malingerers, people with Munchausen syndrome knowingly tell falsehoods, but unlike them, they receive no obvious benefit for doing so, outside of sympathy and attention.

People with Munchausen syndrome deliberately produce or exaggerate symptoms in several ways. They may lie about or fake symptoms, hurt themselves to bring on symptoms, or alter tests (such as contaminating a urine sample). Possible warning signs of Munchausen syndrome include:

  • Dramatic but inconsistent medical history
  • Unclear symptoms that are not controllable and become more severe or change once treatment has begun
  • Predictable relapses following improvement in the condition
  • Extensive knowledge of hospitals and/or medical terminology, as well as the textbook descriptions of illnesses
  • Presence of multiple surgical scars
  • Appearance of new or additional symptoms following negative test results
  • Presence of symptoms only when the patient is with others or being observed
  • Willingness or eagerness to have medical tests, operations, or other procedures
  • History of seeking treatment at numerous hospitals, clinics, and doctors' offices, possibly even in different cities
  • Reluctance by the patient to allow doctors to meet with or talk to family, friends, or prior doctors
  • Problems with identity and self-esteem

The exact cause of Munchausen syndrome is not known, but researchers are looking at the role of biological and psychological factors in its development. Some theories suggest that a history of abuse or neglect as a child or a history of frequent illnesses that required hospitalization might be factors in the development of the syndrome. Researchers are also studying a possible link to personality disorders, which are common in people with Munchausen syndrome.

There are no reliable statistics regarding the number of people in the U.S. who suffer from Munchausen syndrome, but it is considered to be a rare condition. Obtaining accurate statistics is difficult because dishonesty is common with this illness. In addition, people with Munchausen syndrome tend to seek treatment at many different health care facilities, which can lead to misleading statistics.

In general, Munchausen syndrome is more common in men than in women. While it can occur in children, it most often affects young adults.

Diagnosing Munchausen syndrome is very difficult due to the dishonesty involved. Doctors must rule out any possible physical and mental illnesses before a diagnosis of Munchausen syndrome can be considered.

If the doctor finds no physical reason for the symptoms, or if the pattern of reported physical symptoms suggests that they may be self-inflicted, then they will likely refer the person to a psychiatrist or psychologist. Psychiatrists and psychologists are specially trained to diagnose and treat mental illnesses. They use specially designed interview and assessment tools to examine a person for Munchausen syndrome. The doctor bases their diagnosis on the exclusion of actual physical or mental illness and their observation of the patient's attitude and behavior.

Although a person with Munchausen syndrome actively seeks treatment for the various disorders they invent, the person often is unwilling to admit to and seek treatment for the syndrome itself. This makes treating people with Munchausen syndrome very challenging and the outlook for recovery poor.

When treatment is sought, the first goal is to modify the person's behavior and reduce their misuse or overuse of medical resources. Once this goal is met, treatment aims to work out any underlying psychological issues that may be causing the person's behavior. Another key goal is to help patients avoid dangerous and unnecessary medical diagnostic or treatment procedures (such as surgeries), often sought from different doctors who may be unaware that physical symptoms are either being faked or self-inflicted.

As with other factitious disorders, the primary treatment for Munchausen syndrome is psychotherapy or talk therapy (a type of counseling). Treatment usually focuses on changing the thinking and behavior of the individual (cognitive behavioral therapy). Family therapy may also help teach family members not to reward or support the behavior of the person with the disorder.

There are no medications to treat factitious disorders themselves. Medication may be used, however, to treat any related illness, such as depression or anxiety. The use of medications must be carefully monitored in people with factitious disorders due to the risk that the drugs may be used in a harmful way.

People with Munchausen syndrome are at risk for health problems (or even death) resulting from self-harm or intentionally causing symptoms. In addition, they may experience reactions or health problems associated with multiple tests, procedures, and treatments. They are also at high risk for substance abuse and suicide attempts.

Many people with factitious disorders deny they are faking or causing their own symptoms and do not seek or follow treatment. So, their recovery depends on a doctor or loved one recognizing the condition and encouraging them to receive proper medical care for their disorder and sticking with it.

Some people with Munchausen syndrome suffer one or two brief episodes of symptoms. In most cases, however, the disorder is a chronic, or long-term, condition that can be very difficult to treat.

There is no known way to prevent Munchausen syndrome, but treating it as soon as you notice symptoms may help. Munchausen syndrome is difficult to treat, so a health care provider will most likely help manage the condition rather than trying to cure it.

Munchausen syndrome is a condition in which people seek sympathy and attention by faking, exaggerating, or lying about an illness in themselves or in another person (by proxy). People with this disorder may subject themselves to painful tests, procedures, or surgeries. They may sabotage test results or injure themselves deliberately. It's difficult to know how many people may have this disorder, as people with it tend to visit multiple health care locations. Munchausen syndrome is characterized as a mental health disorder, and its exact cause is unknown. However, researchers believe that it may be triggered by psychological trauma such as abuse, neglect, or the loss of a loved one at an early age.

What is Munchausen by proxy called now?

It's now also known as factitious disorder imposed on another (FDIA).

How to know if someone has Munchausen syndrome?

Here is a partial list of symptoms seen in those with Munchausen syndrome:

  • An extraordinary and unpredictable medical history
  • Vague symptoms that worsen or change upon treatment
  • A pattern of relapses after their condition improves
  • Vast, textbook knowledge of illnesses, hospitals, and procedures
  • New symptoms after negative test results
  • Eagerness to subject oneself to extensive and frequent medical tests, procedures, or surgeries
  • A tendency to seek medical treatment at multiple clinics, hospitals, or providers