Malingering Health Dictionary

Munchausen’s syndrome, also known as ‘hospital addiction’ syndrome, is a disorder in which the patient presents repeatedly to hospitals with symptoms and signs (often simulated) suggestive of serious physical illness. More common among men than women, it differs from MALINGERING in that no obvious reward results from the imagined or simulated symptoms. Patients may simulate signs and symptoms in a bizarre way – for instance, by swallowing blood or inserting needles into the chest. Abdominal symptoms are particularly common. They often have a history of multiple hospital admissions and operations, and show extensive pathological lying and lack of personal rapport. Although the cause is unclear, it is thought to be a form of hysterical behaviour in a severely disordered personality. Patients are often masochistic, attention-seeking, and constantly trying to obtain ANALGESICS. Occasionally there may be a degree of treatable DEPRESSION, but on the whole management is very di?cult as patients often abscond from psychiatric treatment.

A variation of the syndrome – Munchausen’s syndrome by proxy, better termed ‘fabricated and induced illness’ – has been identi?ed, in which the persons affected in?ict damage upon others, usually children (or even animals) in their care. Factitious illness refers to simulating symptoms, such as stating that the child has blood in its urine when it is actually the parent’s blood. Induced illness includes such events as injecting dirty water into a baby’s muscles, dropping mild caustic into their eyes, adding salt to a baby’s milk or diluting it 50–50 with water, and so on. Much debate has ensued about the suggestion that some sudden infant deaths are due to smothering rather than natural causes, as a type of induced illness. As a consequence of two successful appeals against conviction for murder in 2004, the UK attorney general ordered a review of all criminal and family court cases in which disputed medical evidence had formed the basis of the decision. Paediatricians are concerned that one result is likely to be an increase in undetected child abuse.... munchausen’s syndrome

A group of disorders in which a patient’s symptoms mimic those of a true illness but which have been invented by, and are controlled by, the patient.

There is no apparent cause for a factitious disorder other than a wish for attention.

The most common disorder of this type, Munchausen’s syndrome, is characterized by physical symptoms.

In a second form, Ganser’s syndrome, there are psychological symptoms.

These disorders differ from malingering, in which the person claims to be ill for a particular purpose, such as obtaining time off work.... factitious disorders

a syndrome characterized by approximate answers, i.e. the patient gives grossly and absurdly false replies to questions, but the reply shows that the question has been understood. For example, the question “What colour is snow?” may elicit the reply “Green”. This can be accompanied by odd behaviour or episodes of *stupor. The condition may be due to *conversion disorder or to conscious malingering, especially (historically) in prisoners. [S. J. M. Ganser (1853–1931), German psychiatrist]... ganser syndrome