He observed, “Like the famous Baron von Munchausen, the persons affected have always traveled widely, and their stories, like those attributed to him (Baron Munchausen) are both dramatic and untruthful” (Ref. In 1951, Richard Asher, a British hematologist and endocrinologist (who incidentally, also coined the term myxoedematous madness) first described “a common syndrome which most doctors have seen, but about which little had been written” (Ref. There is, however, no evidence in the literature of impaired reality testing or any other underlying psychiatric disorder that could account for the behavior. 8, –, 10 Some researchers have proposed that pathological liars do not have the ability to control their lies because the production of lies seems either impulsive or compulsive. When vigorously and persistently challenged, pathological liars may admit to some of their lies, but, more likely, they will alter their lies slightly, change topics and proceed with more lies, or leave the vicinity. Further, the lies are so firmly held that it appears the liar believes them to be true. 8, –, 10 It has been observed that when there appears to be an external reason for lying, the lies are so grossly out of proportion to the apparent gain that they appear senseless.Īlso, it is notable that the magnitude, frequency, or consequences of the lies (to the liar or to others) do not influence or apparently perturb the liar. They include lies that are excessive, extensive, and repeated for no apparent purpose have an external motive or benefit are easily verifiable to be untrue may be elaborate, fantastic, or dazzling may last years or even a lifetime may serve no purpose beyond the lies and may even be damaging to the liar. 7 Although it is still not recognized in the DSM as a free-standing diagnosis, there is no disagreement in the literature on the core elements of the phenomenon. Pathological lying was first described by the German physician Anton Delbruck in 1891.
Pathological Lying ( Pseudologia Fantastica) 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).
Difference between pathological and 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.