Munchausen's syndrome and substance abuse.

The syndrome of factitious disorders with physical symptoms was named "Munchausen's syndrome" by Richard Asher (1951). The present article contains an interesting case report of a patient who has a history of Munchausen's syndrome, substance abuse, and genuine physical illness. A review of the literature supports a strong association of substance abuse in patients with Munchausen's syndrome. Also important for clinicians to remember is that patients with Munchausen's syndrome often have true physical illnesses which need appropriate treatment. The patient described here has successfully begun treatment with methadone maintenance, but further study will be needed regarding methadone maintenance's role in the management of Munchausen's syndrome.