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Chronic Factitious Illness Munchausen's Syndrome

Herzl R. Spiro, MD
Arch Gen Psychiatry. 1968;18(5):569-579. doi:10.1001/archpsyc.1968.01740050057010.
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FACTITIOUS ILLNESS is the appropriate diagnosis in patients who consciously distort their medical history and produce misleading physical findings and laboratory results through self-inflicted lesions. By simulating patterns of physical disease, these patients may cause themselves to be subjected to painful and dangerous diagnostic and treatment procedures.

"Munchausen's syndrome" represents a special pattern within the group of factitious illnesses. It is characterized by marked chronicity and the tendency of these patients to wander from hospital to hospital and city to city. Bean describes those afflicted with the syndrome as follows:

At the frayed end of . . . (the human) spectrum is the fascinating derelict, human flotsam detached from its moorings, the peripatetic medical vagrant, the itinerant fabricator of nearly perfect facsimile of serious illness—the victim of Munchausen's Syndrome.1

Terminology.—The terminology used in describing this disorder is better noted for its color than for its clarity.


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