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Munchausen Syndrome, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • A neurotic disorder in which the patient fakes signs or symptoms without tangible personal benefit other than to experience the sick role.

  • Most dramatic form of chronic factitious dis...

Diagnosis

Signs and Symptoms

History

  • Inappropriate or bizarre use of the ED

  • Frequent visits

  • Numerous hospital admissions

  • Peregrination: Travel from hospital to hospital

  • Pseudologia fantastica:

    • Intricate and ...

Treatment

Initial Stabilization/Therapy

Treatment should be limited to stabilization of life or limb threats caused by acts of self-harm 

Ed Treatment/Procedures

  • Identify objective physical illness and t...

Follow-Up

Disposition

Admission Criteria

  • Injuries and disease caused by self-harm

  • Munchausen by proxy:

    • When the diagnosis is suspected but there is not enough evidence to have child protective services ta...

Additional Reading

  • Kenedi  CA, Shirey  KG, Hoffa  M, et al. Laboratory diagnosis of factitious disorder: A systematic review of tools useful in the diagnosis of Munchausen's syndrome. N Z Med J.  ...

Codes

ICD9

301.51 Chronic factitious illness with physical symptoms 

ICD10

  • F68.11 Factitious disorder w predom psych signs and symptoms

  • F68.12 Factitious disorder w predom physical signs and symptoms

  • F68.1...

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