DSM-III differential diagnosis of Munchausen's syndrome

Patients who have the wish to be admitted and treated repeatedly in hospitals are a fascinating although still poorly understood group. Those who have no apparent organic basis for their complaints are especially interesting and challenging, since they often demand and sometimes receive potentially dangerous somatic treatments such as operations and medications. Such patients receive a wide range of psychiatric diagnoses, such as hysteria, Briquet's syndrome, factitious illness, Munchausen's syndrome, malingering, and schizophrenia. We recently treated a young woman who had been given most of these diagnoses, whose case history presented us with an opportunity to review problems in differential psychiatric diagnosis as applied to this frequently confused and confusing problem area.