If in doubt, consult the appropriate specialist for the purported illness and arrange for admission to the hospital. If the diagnosis of Munchausen syndrome is quite clear, psychiatric consultation and referral should be offered to the patient even if admission for the patient's medical problems is declined. The patient nearly always declines such referrals, and a refusal should be documented in the patient's record. The first category is necessarily vast because patients with Munchausen syndrome have portrayed nearly every disease known to medicine. There is no evidence that antipsychotic drugs have had any effect on the course or prognosis of Munchausen syndrome.
Inpatient admission is dictated by the presenting symptoms.
As mentioned in Procedures , there will come a time in the care of a patient with Munchausen syndrome when the suspicion that the patient has a factitious illness has arisen but evidence is insufficient to be certain of that diagnosis. As in an authentic disease, if a constellation of symptoms has placed, or appears to have placed, the patient in significant danger that cannot be addressed by the resources of the initial hospital, transfer to a secondary or tertiary referral center should be arranged in accordance with the federal law and established clinical practice. Manifold complications may occur from the simulation of symptoms, depending upon the technique that the patient used to induce such symptoms. The severity of complications may range from trivial to lethal. The prognosis for patients with Munchausen syndrome generally is poor.