Münchhausen syndrome: psychopathology and management

A case report on a patient with Münchhausen syndrome is presented and the psychopathological features are compared to other reports in the literature. Diagnosis and differential diagnosis are discussed with regard to other somatoform disorders such as conversion disorder and somatization disorder as well as to malingering and cenesthesic schizophrenia. The management of Münchhausen syndrome is aggravated by the low compliance in these patients, who expose themselves to serious complications of unnecessary medical and surgical procedures. Early diagnosis could to a considerable extent exclude these iatrogenic risks. We recommend that patients presenting the psychopathological features of a Münchhausen syndrome should be conservatively observed and an attempt to clarify both the medical and the psychiatric diagnosis should be made before any invasive procedure is undertaken.