Munchausen by Internet: detecting factitious illness and crisis on the Internet.

Within the past few years, the Internet has exploded into a medium of choice for those interested in health and medicine. Along with the promise of immediate access to authoritative resources via websites, the Internet offers "virtual support groups" through formats such as chat rooms and newsgroups. These person-to-person exchanges, typically focusing on a specific topic, can be invaluable sources of information and compassion for patients and their families. However, individuals may misuse these Internet groups at times, offering false stories of personal illness or crisis for reasons such as garnering attention, mobilizing sympathy, acting out anger, or controlling others. I present four such cases and, based on experience with these and other cases of "virtual" factitious disorder and Munchausen by proxy, summarize indicators of factitious Internet claims and the reactions that participants usually experience once the ruse is recognized.