Munchausen's syndrome. A study of the casualty "Black books" of Melbourne.
Unofficial registers or casualty "Black books" have evolved to assist busy casualty department staff in the identification of patients who are suffering from Munchausen's syndrome, are drug abusers or have other "problem" disorders. Fourteen of Melbourne's 17 general public hospitals have such books which contain information on 835 patients. Amalgamation of information from all of these books reduced this to 713 individual patients, of whom 21 were regarded as cases of Munchausen's syndrome, 20 were probable cases, 652 were classified as drug abusers and 20 were classified as dangerous patients. All four groups shared a similar mean age, between 32 and 37 years. Munchausen's syndrome patients showed greater tendency to use aliases. Men predominated in all four groups, especially among dangerous patients. Conventional records rely upon obtaining an honest and accurate name and information from the patient and are quite inadequate for the identification and treatment of patients with Munchausen's syndrome and drug abusers. When these conditions are suspected, a detailed standard identification form, suitable for computerization, should be used at all hospitals.
D000328:Adult; D001315:Australia; D003617:Dangerous Behavior; D005260:Female; D006801:Humans; D008297:Male; D009110:Munchausen Syndrome / Q000191:economics / Q000453:epidemiology*; D012042:Registries; D019966:Substance-Related Disorders / Q000453:epidemiology