The authors describe two patients with Munchausen syndrome who met DSM-
III criteria for major depression. Both patients exhibited evidence of
nonsuppression of serum cortisol by dexamethasone. Although many patients
with Munchausen syndrome have been reported to be depressed, only a few
have received a diagnosis of major depression. Because the physical and
psychiatric symptoms of the Munchausen patient are so complex, clinical
assessment may stop at a diagnosis of Munchausen syndrome, and major
depression may be overlooked. A diagnosis of major depression should be
considered in the evaluation of these patients; the dexamethasone
suppression test may enhance clinical assessment.
Abstract Teaser