A case of chronic factitious illness.

A twenty-four-year-old woman is presented with multiple previous hospitalizations for joint and muscle pains. Guarded in her description of symptoms, she reports that "lupus" has been diagnosed at several hospitals over the past few years, unable to recall the name of any other than on previous hospital. The medical work-up failed to show any abnormality except that compatible with previously diagnosed von Willebrand's disease. In the discussion of the case, the patient's desire to be taken care of is seen as a major dynamic, causing her to fabricate illness. The diagnoses of Munchausen Syndrome, malingering, conversion reaction and hypochondriasis are discussed and differentiated from each other, and the treatment of Munchausen Syndrome is discussed.