Am J Psychiatry 1984; 141:570-572
Copyright © 1984 by American Psychiatric Association
Munchausen syndrome, depression, and the dexamethasone suppression test
DL Evans, JK Hsiao and CB Nemeroff
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.
