Abstract
Self‐induced, or factitious, illness is probably more common than it is thought to be, as the condition often goes undetected or is never proved. At its most florid (Munchausen's syndrome), the extent to which patients go to influence the diagnosis and treatment is remarkable. Once this clever deception and pathological lying are uncovered, patients with Munchausen's syndrome become belligerent and usually promptly discharge themselves from hospital. A high index of suspicion is warranted whenever a patient has an abnormal psychiatric history or has worked in the paramedical field.

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