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September 1959

Psychodynamic Factors in Munchausen's Syndrome

Author Affiliations

U. S. A. F.; Bryan, Texas

Resident in Medicine, University Hospitals, Oklahoma City (Capt. Rhoades), and Director, Brazos County Youth Development Service (Mr. Toland).

AMA Arch Intern Med. 1959;104(3):427-429. doi:10.1001/archinte.1959.00270090081014

The term "Munchausen's syndrome" was applied by Asher1 to describe a type of bizarre behavior, manifested by recurrent episodes of apparently feigned organic illness or factitious bleeding often associated with multiple surgical scars upon the abdomen, an evasive manner, and a fantastic personal history replete with amazing adventures and extraordinary achievements. Patients with this behavior have been called "peregrinating problem patients" by Chapman 2 because they travel from hospital to hospital causing consternation to the staff. Relatively little has been learned about the syndrome since Asher's report in 1951, and there is a notable lack of published data on possible psychodynamic factors. This is apparently a result of the recalcitrant nature of these patients.

The present report describes a patient who displayed the characteristics of Munchausen's syndrome and whose life history provided a basis for an understanding of possible causative factors.

Report of Case  The patient was a 34-year-old