Munchausen syndrome is diagnosed when a patient falsely reports and/or portrays mostly physical – or, sometimes, mental – signs or symptoms for the purpose of occupying a “sick role.” Also, the patient must not have other motives, such as those associated with malingering (feigned illness for the purpose of material gain).

Another mental disorder that presents with physical symptoms in the absence of diagnosable medical disorders is somatization disorder.  However, in contrast to those with Munchausen syndrome, patients with somatization disorder are honestly reporting their symptoms and do not seek to deceive healthcare professionals.

At first, it may not be obvious to a physician that a patient is faking symptoms. During an initial visit, a physician is likely to perform a complete physical examination and compile a thorough medical history. Various tests may be performed to try to identify the source of the patient’s complaints.

However, over time, it may become more obvious that the patient is faking the illness or has self-inflicted injuries. Patient history of multiple procedures and hospitalizations may offer one clue. Continuous complaints of new symptoms and constant requests for analgesics may offer other clues. Patients with Munchausen syndrome also have a tendency to falsely claim certain accomplishments, friendships with famous people or to make other similar self-aggrandizing claims.

Once a physician suspects a patient of feigning illness, a psychiatrist, psychologist or other mental health professional may be brought in to help diagnose the patient’s true disorder. The patient’s medical history and results from psychological testing may be combined with results of physical and laboratory tests to help reach a diagnosis.

The physician and mental health professional are likely to ask themselves several questions. These include:

• Do the patient’s test results make sense in light of the reported symptoms?
  
  
• Do outside sources seem to corroborate the patient’s claims?
  
  
• Is the patient reluctant to share information from other sources?
  
  
• Does the patient appear especially eager to undergo procedures or testing?
  
  
• Are the patient's treatments working as predicted?

Munchausen syndrome may be diagnosed when it is clear that the patient is intentionally faking physical or psychological symptoms with the sole motivation of assuming the sick role. When confronted, patients will usually deny that they are making up their symptoms. It is common for patients to move on to various physicians and hospitals to continue the ruse. In some cases, patients may seek medical care in another city, state or even another country.

Once a physician suspects Munchausen syndrome, the patient may be evaluated for other associated disorders. These include chemical dependency, depression and other mental health disorders.