Our objective was to describe current use of Munchausen files in Scottish A
ccident and Emergency Departments. A Postal questionnaire survey was sent t
o lead A&E consultant/clinical directors in each department in Summer 1998.
A total of 29 departments replied with 27 saying they kept a Munchausen fi
le, of which only two were updated regularly. Organisation of information w
as variable or absent. Six departments kept data on other groups such as dr
ug misusers, violent patients, missing persons or children at risk in the s
ame file. Of the 27 replies, only 14 departments would review their own fil
es if suspecting a case: only 11 would report a suspected incident, to a va
riety of destinations. The majority of Scottish A&E departments do keep a M
unchausen file although there appears to be little consistency in the colle
ction, use and dissemination of the information therein. An improved data s
ystem may lead to more appropriate patient management.