The British Journal of Psychiatry
The Syndrome of Hospital Addiction(Munchausen Syndrome)
A Report on the Investigation of Seven Cases
J. C. Barker


Seven examples of a syndrome described originally by Asher and associated with the name of Baron Munchausen are reported. These patients spent much of their lives in hospitals with fictitious symptoms that were usually dramatic, indulged in pathological lying (pseudologia phantastica) and submitted to repeated unnecessary operations and protracted investigations. The term Munchausen Syndrome is considered inappropriate in that it implies that these cases form a distinct clinical entity, refers only to their pseudologia and confers ridicule upon them, so “The Syndrome of Hospital Addiction” has been proposed as an alternative title to this paper since it is not open to these objections.

The principal features of the syndrome have been described and tabulated. The observation that three of these patients may have sustained brain damage prior to the commencement of their hospital addiction is of particular interest, since this may have provided an organic basis for their aberrant behaviour.

Motivation is largely unknown, but recognition that these patients are mentally rather than physically ill is required, so that they may be given treatment to prevent them from destroying themselves. Further research is necessary, directed to ascertaining the natural history of the disease, providing a better understanding of the personality disorder and improving methods of psychiatric treatment for this condition.

Following conviction before a criminal court, legal machinery now exists to detain a patient suffering from this syndrome for a prolonged period in a specified mental hospital (27). Under these circumstances it is suggested that the provisions of the Mental Health Act should be applied wherever possible to future cases, so that they may be admitted to psychiatric hospitals for investigation and treatment. In view of their tendency to abscond from “open door” mental hospitals, admission to a special security hospital (28) may enable therapy to be more effectively administered.


  • * This research was undertaken while the author was at Banstead Hospital and has been abstracted from an M.D. thesis accepted by the University of Cambridge in March 1960.