The making of a Munchausen.

The author presents a developmental case history of a Munchausen patient in an effort to understand the evolution of the behavioural patterns associated with the syndrome. The case history documents a pattern of behaviour characterized by: frequent hospitalizations for diffuse ailments, beginning in infancy and persisting into adulthood; inadequate acquisition of appropriate social values and behaviours within the context of the nuclear family; persistent difficulties in adjusting to the demands of school, as expressed in poor academic performance, delinquent behaviour, and poor peer relationships; conflicted social role behaviour regarding work performance, criminal behaviour, and increased abuse of health care services; eventual severance of family ties and the adoption of a 'hobo' life-style which utilizes hospitals for social support and personal definition. This case is compared with a similar study, recently published, and the affinities between the developmental histories and diagnostic criteria descriptive of 'antisocial personality disorder' are emphasized.