I will then propose a radical shift in the relationship between factitious disorder and pathological lying. Further, I present highlights of a recent case reported in the media where both phenomena were prominently described. In this article, I review the descriptions of pathological lying and factitious disorder (Munchausen syndrome) in the literature, highlighting the salient presenting symptoms and features. A review of the literature reveals a historical relationship between these two phenomena that not only questions the rationale for decoupling them in DSM-5, but in fact raises the even bigger question of whether the DSM Committee got the relationship between them wrong from the start. They are, however, real entities seen in regular psychiatric and medical practice, where they pose an enduring conundrum regarding their definition, etiology, investigation, and management. Pathological lying and factitious disorder are poorly understood and controversial conditions. Surprisingly, however, the association between the two phenomena was dropped in DSM-5 6 there is no mention of pathological lying under factitious disorder.
They also state, in similar language, that individuals with factitious disorder with predominantly physical symptoms “may indulge in uncontrollable, pathologic lying, in a manner intriguing to the listener, about any aspect of their history or symptoms ( pseudologia fantastica)” (Ref. These versions of the DSM state that the best studied form of factitious disorder has been called Munchausen syndrome. 2 Pathological lying and factitious disorder (sometimes used interchangeably with Munchausen syndrome) maintained their connection through various iterations of the DSM from DSM-III to DSM-IV-TR 3 (including DSM-III-R 4 and DSM-IV 5).
PATHOLOGICAL LIAR VS COMPULSIVE LIAR MANUAL
1 The association was concretized in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), when factitious disorder diagnosis first came to light. Pathological lying (also known as pseudologia fantastica or phantastica) has been associated with Munchausen syndrome since 1951 when Asher first coined the term Munchausen syndrome.
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