Munchausen syndrome (factitious disorder)

Medical disclaimer: This page is general health information for education only. It is not medical advice and is not a substitute for diagnosis or treatment by a qualified health professional. It has not been reviewed by a clinician. In an emergency, call 911 or your local emergency number.

Munchausen syndrome is the older name for factitious disorder imposed on self, a mental health condition in which a person fakes, exaggerates or causes symptoms of illness without an outside reward. You may have met the term in a psychology course or a news report. This page explains the current clinical name, where the old name came from, how the condition differs from similar ones and how clinicians approach care. It is part of our library of health conditions.

This page is general education. It cannot tell you whether any specific person has this condition, and it is not a guide to judging someone you know.

What is Munchausen syndrome?

Munchausen syndrome is now called factitious disorder imposed on self, a condition involving deliberately false or self-induced symptoms.

• Factitious disorder imposed on self means pretending to have or producing physical or psychological symptoms for no apparent external reason.
• Merck Manual notes this condition was previously called Munchausen syndrome.
• Factitious disorder falls under somatic symptom and related disorders in the DSM-5.
• The DSM-5 describes two types: factitious disorder imposed on self and factitious disorder imposed on another.
• The cause is unknown, but stress and a severe personality disorder may contribute.

These points come from the Merck Manual consumer page on factitious disorder imposed on self and the StatPearls overview of factitious disorder hosted by the National Library of Medicine. DSM-5 stands for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the manual US clinicians use to classify mental health conditions.

Some researchers use “Munchausen syndrome” for a narrower, more severe subtype rather than the whole condition. That subtype involves frequent moves from one hospital to another and elaborate false life stories. This section does not describe how any individual is diagnosed. Only a qualified clinician can make that judgment after a full evaluation.

Where does the name Munchausen come from?

Psychiatrist Richard Asher introduced the term “Munchausen syndrome” in 1951, naming it after Baron Munchausen.

• Baron Munchausen was a German aristocrat famous for telling exaggerated stories about his life.
• Cleveland Clinic describes him as an 18th-century German officer who embellished stories of his experiences.
• The name reflects the storytelling side of the condition, not its complexity as a mental health condition.

The naming history is summarized in the StatPearls factitious disorder overview. Cleveland Clinic gives the officer description in its page on factitious disorder imposed on self. For more on how medical terms change over time, see our history of medicine overview.

The DSM-5 groups this condition under the factitious disorder names, not under Munchausen. This page uses the current names except when discussing history.

How is factitious disorder different from malingering and somatic symptom disorder?

Factitious disorder involves deliberate deception without outside rewards, malingering seeks outside rewards and somatic symptom disorder involves real symptoms.

Merck Manual explains that people with factitious disorder resemble malingerers because their actions are conscious and intentional. Unlike malingerers, they are not motivated by external rewards. Somatic symptom disorder occurs when a person feels extreme, exaggerated anxiety about physical symptoms. A person with somatic symptom disorder is not faking their symptoms, as MedlinePlus explains in its somatic symptom disorder article.

This comparison is for understanding terms only. It is not a tool for deciding whether a person you know is faking, and it does not cover every condition clinicians consider.

What is factitious disorder imposed on another?

Factitious disorder imposed on another, formerly Munchausen syndrome by proxy, is falsifying or producing illness in someone else, and it is a form of abuse.

• It is usually done by caregivers, typically parents, to someone in their care.
• Victims are typically a child, a dependent adult or a pet.
• MedlinePlus calls Munchausen syndrome by proxy a mental illness and a form of child abuse.
• Children younger than 6 years are the most common victims.
• Because it is child abuse, the condition must be reported to the authorities.

These facts come from the MedlinePlus article on Munchausen syndrome by proxy, the Merck Manual page on factitious disorder imposed on another and the StatPearls review. The first priority in care is protecting the child.

If you are worried a child is being abused: call 911 if the child is in immediate danger. You can also contact your local child protective services, the police or a health care provider. The Childhelp National Child Abuse Hotline is 1-800-422-4453 (1-800-4-A-CHILD). You can call or text, and counselors are available 24 hours a day in over 170 languages, according to the Child Welfare Information Gateway.

This section does not list warning signs for judging a particular family. Trained child protection and medical teams make those assessments.

How do clinicians approach care?

Clinicians aim to avoid harmful tests and procedures and to offer mental health support with empathy rather than confrontation.

• Early psychiatric or psychological consultation helps avoid risky invasive testing and unnecessary surgery.
• Merck Manual advises a nonaggressive, nonpunitive, nonconfrontational approach when presenting the diagnosis.
• Psychotherapy is the primary treatment, although most patients decline it.
• Experts often recommend a team that can include nurses, psychiatrists, primary care clinicians, therapists and family members.
• There are no clearly effective treatments, but psychotherapy may help.

These approaches are described in the Merck Manual professional guidance and the StatPearls review. Cleveland Clinic states that the first goal of treatment is to change harmful behaviors and reduce overuse of medical resources. If you are a family member, a health care provider or mental health professional can advise you on how to offer support. Our guide to understanding your care explains how care teams work together.

This section describes general clinical practice. It is not a treatment plan for any person. If you or someone you know is thinking about self-harm, call 988 to reach the Suicide and Crisis Lifeline.

Questions to bring to your appointment

If you are a student, family member or patient, these questions can help you talk with a clinician. Our tips on how to prepare for an appointment may also help.

• How is factitious disorder diagnosed, and which other conditions are ruled out first?
• How is factitious disorder different from somatic symptom disorder in practice?
• What kind of mental health professional treats factitious disorder?
• How can family members offer support without confrontation?
• Where can I find reliable reading on the history of the term Munchausen syndrome?
• Who should I contact if I have concerns about a child’s safety?