Factitious disorder Munchausens syndrome

This is listed in ICD as F68.1 Intentional production or feigning of symptoms or disabilities, either physical or psychological [factitious disorder]. (This is in a different chapter, namely, Disorders of adult personality and behaviour (F60—F69).)

Patients contrive repeated hospital admissions by fabricating acute physical symptoms such as bleeding or acute abdominal pain. They usually give a dramatic history, sometimes under a false name. They may submit to unpleasant investigations, or even to surgery, before suddenly discharging themselves when detection is imminent and travelling to another hospital to repeat a similar performance. Some patients go so far as to inject themselves with noxious material in order to produce fever, or to pick at a surgical wound to prevent its healing. Alternative terms quoted in the ICD include hospital hopper syndrome and peregrinating patient. The patient appears to crave the attention and succour derived from hospital care; it is not done for external gain, which is the main distinguishing feature from malingering (see below).

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