Munchausen Syndrome Differential Diagnoses

  • Author: James C Hamilton, PhD; Chief Editor: Eduardo Dunayevich, MD   more...
 
Updated: Jun 7, 2011
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

James C Hamilton, PhD  Associate Professor, Coordinator of Clinical Health Psychology, Department of Psychology, Clinical Affiliate Associate Professor of Internal Medicine, University of Alabama

James C Hamilton, PhD is a member of the following medical societies: American Psychological Society, American Psychosomatic Society, International Society for Self and Identity, Phi Beta Kappa, and Society for Personality and Social Psychology

Disclosure: Nothing to disclose.

Coauthor(s)

Marc D Feldman, MD  Clinical Professor of Psychiatry, Department of Psychiatry and Behavioral Medicine, and Adjunct Professor, Department of Psychology, University of Alabama, Tuscaloosa, AL

Marc D Feldman, MD is a member of the following medical societies: Academy of Psychosomatic Medicine and American Psychiatric Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Ronald C Albucher, MD  Chief Medical Officer, Westside Community Services; Consulting Staff, California Pacific Medical Center

Ronald C Albucher, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Harold H Harsch, MD  Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin

Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: lilly Honoraria Speaking and teaching; Forest Labs None None; Pfizer Grant/research funds Speaking and teaching; Northstar None None; Novartis Grant/research funds research; Pfizer Honoraria Speaking and teaching; Sunovion Speaking and teaching; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research; Merck Honoraria Speaking and teaching

Chief Editor

Eduardo Dunayevich, MD  Adjunct Assistant Professor, Department of Psychiatry, University of Cincinnati; Clinical Research Physician, Neuroscience, Lilly Research Laboratories

Eduardo Dunayevich, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: Nothing to disclose.

References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC, American Psychiatric Association. 2000.

  2. Mountz JM, Parker PE, Liu HG, Bentley TW, Lill DW, Deutsch G. Tc-99m HMPAO brain SPECT scanning in Munchausen syndrome. J Psychiatry Neurosci. Jan 1996;21(1):49-52. [Medline].

  3. Sutherland AJ, Rodin GM. Factitious disorders in a general hospital setting: clinical features and a review of the literature. Psychosomatics. Fall 1990;31(4):392-9. [Medline].

  4. Fliege H, Grimm A, Eckhardt-Henn A, Gieler U, Martin K, Klapp BF. Frequency of ICD-10 factitious disorder: survey of senior hospital consultants and physicians in private practice. Psychosomatics. Jan-Feb 2007;48(1):60-4. [Medline].

  5. Plassmann R. Inpatient and outpatient long-term psychotherapy of patients suffering from factitious disorders. Psychother Psychosom. 1994;62(1-2):96-107. [Medline].

  6. Aduan RP, Fauci AS, Dale DC. Factitious fever and self-induced infection: a report of 32 cases and review of the literature. Ann Intern Med. Feb 1979;90(2):230-42. [Medline].

  7. ASHER R. Munchausen's syndrome. Lancet. Feb 10 1951;1(6650):339-41. [Medline].

  8. Babe KS Jr, Peterson AM, Loosen PT. The pathogenesis of Munchausen syndrome. A review and case report. Gen Hosp Psychiatry. Jul 1992;14(4):273-6. [Medline].

  9. Baile WF Jr, Kuehn CV, Straker D. Factitious cancer. Psychosomatics. Winter 1992;33(1):100-5. [Medline].

  10. Eastwood S, Bisson JI. Management of factitious disorders: a systematic review. Psychother Psychosom. 2008;77(4):209-18. [Medline].

  11. Ehlers W, Plassmann R. Diagnosis of narcissistic self-esteem regulation in patients with factitious illness (Munchausen syndrome). Psychother Psychosom. 1994;62(1-2):69-77. [Medline].

  12. Feldman MD. Playing Sick?: Untangling the Web of Munchausen Syndrome, Munchausen by Proxy, Malingering, and Factitious Disorder. New York, Routledge. 2004.

  13. Feldman MD. Web alert. Curr Psychiatry Rep. Oct 2000;2(5):367-8. [Medline].

  14. Feldman MD, Eisendrath SJ. The Spectrum of Factitious Disorders. Washington, DC: American Psychiatric Press; 1996.

  15. Feldman MD, Hamilton JC. "Chest pain" in patients with factitious disorder including Munchausen syndrome. In: Hurst JW, Morris DC, eds. Chest Pain. Armonk, NY: Futura; 2001.

  16. Feldman MD, Hamilton JC. Serial factitious disorder and Munchausen by proxy in pregnancy. Int J Clin Pract. Dec 2006;60(12):1675-8. [Medline].

  17. Feldman MD, Miner ID. Factitious Usher syndrome: a new type of factitious disorder. Medscape Journal of Medicine [serial online]. June 30, 2008;10:153. Available from: http://www.medscape.com/viewarticle/575253. Accessed March 22, 2009. Available at www.medscape.com/viewarticle/575253.

  18. Folks DG. Munchausen's syndrome and other factitious disorders. Neurol Clin. May 1995;13(2):267-81. [Medline].

  19. Folks DG, Feldman MD, Ford CV. Somatoform disorders, factitious disorders, and malingering. In: Stoudemire A, Fogel BS, Greenberg DB, eds. Psychiatric Care of the Medical Patient. 2nd ed. New York: Oxford University Press; 2000:459-475.

  20. Gattaz WF, Dressing H, Hewer W. Munchhausen syndrome: psychopathology and management. Psychopathology. 1990;23(1):33-9. [Medline].

  21. Gavin H. On Feigned and Factitious Diseases. London, England: John Churchill; 1843.

  22. Hamilton JC, Feldman MD. Factitious disorders. In: Phillips KA, ed. Somatoform and Factitious Disorders. Washington, DC: American Psychiatric Publishing; 2001:129-166.

  23. Hamilton JC, Feldman MD, Janata JW. The A, B, C's of factitious disorder: a response to Turner. Medscape J Med. 2009;11(1):27. [Medline]. [Full Text].

  24. Krahn LE, Bostwick JM, Stonnington CM. Looking toward DSM-V: should factitious disorder become a subtype of somatoform disorder?. Psychosomatics. Jul-Aug 2008;49(4):277-82. [Medline].

  25. Krahn LE, Li H, O'Connor MK. Patients who strive to be ill: factitious disorder with physical symptoms. Am J Psychiatry. Jun 2003;160(6):1163-8. [Medline].

  26. Turner MA. Factitious disorders: reformulating the DSM-IV criteria. Psychosomatics. Jan-Feb 2006;47(1):23-32. [Medline].

 
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Baron Munchausen as he has been depicted in innumerable books. The real-life Baron Munchausen lived from 1720-1797 and never told tales about illness.
A playing card celebrating the literary Baron, who claimed to have ridden a cannonball into battle.
The classic, multiply scarred abdomen of a patient with Munchausen syndrome. The photograph on the left shows her abdomen as it appeared on presentation, after she had undergone 42 unwarranted operations. The photograph on the right shows her abdomen after additional surgery revealed an authentic colon cancer.
An antique gyroscope showing Baron Munchausen riding a cannonball into battle as in the famous story attributed to him.
 
 
 
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