Introduction

Patients with factitious disorder feign or simulate illness, are considered not to be aware of the motives that drive them to carry out this behaviour, and keep their simulation or induction of illness secret. In official psychiatric nomenclature, factitious disorder has replaced the eponym Munchausen syndrome, introduced by Asher(1) to describe patients with chronic factitious behaviour. Asher borrowed the term from Raspe's 1785 fictional German cavalry officer, Baron Karl von Munchausen, who always lied, albeit harmlessly, about his extraordinary military exploits.

Munchausen syndrome was defined as follows:

1. dramatic presentation of physical complaints;

2. pathological lying (pseudologia fantastica);

3. pathological wandering.(2)

It became evident, however, that this stereotype was misleading if used incorrectly to describe all patients with factitious disorders. The label blurs important distinctions among the various types of factitious disorders; whereas Munchausen syndrome is generally applied to wandering untreatable male sociopaths, most factitious disorder patients are women and do not conform to this stereotype.

This section concentrates on factitious physical complaints; fabricated psychological symptoms are considered under malingering.

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