Abstract
Objective To present an algorithm for the diagnosis of Münchausen’s syndrome (MS) in patients with eating disorders (ED). Method Case reports and review of the literature using PubMed. Results Two cases diagnosed with anorexia nervosa (AN): one later diagnosed with MS and one with Münchausen’s syndrome by proxy (MSBP) are presented. We then present an algorithm to aid in the diagnosis of MS and MSBP in patients with eating disorders. Discussion EDs can be distinguished from MS by their distinctive psychopathological traits, including fear of weight gain, eating and shape concerns, and food restraint. However, the diagnosis of concurrent ED and MS can be difficult because patients with both disorders may manifest similar abnormal behaviours: self-injurious behaviour, manipulation, splitting, physical complaints, multiple admissions, non-compliance, and giving false information. We present an algorithm as an aid to the diagnosis of concurrent MS and ED.
Similar content being viewed by others
References
Huffman J.C., Stern T.A.: The diagnosis and treatment of Munchausen’s syndrome. Gen. Hosp. Psychiatry, 25, 358–363, 2003.
Asher R.: Munchausen’s syndrome. Lancet, 1, 339–341, 1951.
Stern T.A.: Munchausen’s syndrome revisited. Psychosomatics, 21, 329–331, 335–326, 1980.
Folks D.G., Freeman A.M.: 3rd: Munchausen’s syndrome and other factitious illness. Psychiatr. Clin. North Am., 8, 263–278, 1985.
Meadow R.: Different interpretations of Munchausen syndrome by proxy. Child Abuse Negl., 26, 501–508, 2002.
Lieder H.S., Irving S.Y., Mauricio R., Graf J.M.: Munchausen syndrome by proxy: a case report. AACN Clin Issues, 16, 178–184, 2005.
Rosenberg D.A.: Web of deceit: a literature review of Munchausen syndrome by proxy. Child Abuse Negl., 11, 547–563, 1987.
Krahn L.E., Lee J., Richardson J.W., Martin M.J., O’Connor M.K.: Hypokalemia leading to torsades de pointes. Munchausen’s disorder or bulimia nervosa? Gen. Hosp. Psychiatry, 19, 370–377, 1997.
Burge C.K., Lacey J.H.: A case of Münchausen’s syn drome in anorexia nervosa. Int. J. Eat. Disord., 14, 379–381, 1993.
Mizuta I., Fukunaga T., Sato H., Ogasawara M., Takeda M., Inoue Y.: A case report of comorbid eating disorder and factitious disorder. Psychiatry Clin. Neurosci., 54, 603–606, 2000.
Bulik C.M., Sullivan P.F., Fear J.L., Pickering A.: A case of comorbid anorexia nervosa, bulimia nervosa, and Munchausen’s syndrome. Int. J. Eat. Disord., 20, 215–218, 1996.
Vanelli M.: Munchausen’s syndrome by proxy webmediated in a child with factitious hyperglycemia. J. Pediatr., 141, 839, 2002.
Paul T., Schroeter K., Dahme B., Nutzinger D.O.: Selfinjurious behavior in women with eating disorders. Am. J. Psychiatry, 159, 408–411, 2002.
Carney C.P., Andersen A.E.: Eating disorders. Guide to medical evaluation and complications. Psychiatr. Clin. North Am., 19, 657–679, 1996.
Sansone R.A., Levitt J.L.: Borderline personality and eating disorders. Eat. Disord., 13, 71–83, 2005.
Noordebons G., Oldenhave A., Muschter J., Terpstra N.: Characteristics and treatment of patients with chronic eating disorders. Eat. Disord., 10, 15–29, 2002.
Bauer M., Boegner F.: Neurological syndromes in factitious disorder. J. Nerv. Ment. Dis., 184, 281–288, 1996.
Aduan R.P., Fauci A.S., Dale D.C., Herzberg J.H., Wolff S.M.: Factitious fever and self-induced infection: a report of 32 cases and review of the literature. Ann. Intern. Med., 90, 230–242, 1979.
Marks V., Teale J.D.: Hypoglycemia: factitious and felonious. Endocrinol. Metab. Clin. North Am., 28, 579–601, 1999.
Chen D.K., So Y.T., Fisher R.S.: Use of serum prolactin in diagnosing epileptic seizures: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 65, 668–675, 2005.
Tyler I., Wiseman M.C., Crawford R.I., Birmingham C.L.: Cutaneous manifestations of eating disorders. J. Cutan. Med. Surg., 6, 345–353, 2002.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Birmingham, C.L., Sidhu, F.K. An algorithm for the diagnosis of Münchausen’s syndrome in eating disorders. Eat Weight Disord 12, e74–e77 (2007). https://doi.org/10.1007/BF03327598
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03327598