![]() 1 A review of 72 cases reported that the average age at onset of the lying behavior was 16 and the average age at discovery was 22. Although its prevalence in the general population is unknown, one study of 1000 repeat juvenile offenders found a prevalence of close to 1%. Over the years, very little has been written on the epidemiology of PL. Throughout this article, PL and pseudologia phantastica will be used synonymously. It is not yet clear whether these different names refer to the same phenomenon, but they are often used interchangeably. Lying is a common human trait defined by Merriam-Webster's Collegiate Dictionary as making "an untrue statement with intent to deceive." Selling 3 agreed, with an observation that "everyone lies and you can't stop them," and concluded, "of course, that is the truth." PL is commonly referred to as pseudologia phantastica (or pseudologia fantastica) and, less commonly, as mythomania, or morbid lying. Was his lying behavior completely within his control, or was there something different about his pattern of lies? Why such a successful individual would repeatedly tell lies that could damage his credibility and put him in trouble with the law or other administrative bodies is baffling. 2 A psychiatric expert witness diagnosed pseudologia phantastica and suggested that the judge needed treatment. Even prominent and successful individuals are not immune to this behavior-for example, the well-known California case of Judge Patrick Couwenberg, who was removed from office not only for lying in his official capacity but also for lying under oath to a commission investigating his behavior. Letters I have received from mental health professionals, attorneys, and individuals around the world describe similar characteristics in people they know-excessive lying, easily verifiable to be untrue, mostly unhelpful to the liar in any apparent way, and even possibly harmful to the liar, yet told repeatedly over time. This scenario, or similar stories, is not uncommon in clinical practice. Mr A finally sought psychiatric help after concluding that he could not stop himself from lying. Family members reported that he often told blatant lies, and even when confronted, and proved wrong, he still swore they were true. Mr A had lost several other jobs in the past because of his lying, and he was becoming frustrated. On the face of it, it would seem Mr A told these lies to gain the sympathy of his colleagues, but the consequences of his lying, in terms of emotional distress and potential loss of job, far outweighed any perceived gain. ![]() Finally, when the heat became too unbearable, he suddenly stopped going to work. He had to tell more and more outrageous lies to cover his tracks and justify having a terminal illness. Initially, his coworkers treated him with sensitivity and concern, but as the weeks wore on, the scrutiny of his colleagues became increasingly pointed. He had lied repeatedly to his colleagues, telling them that he had an incurable disease and was receiving palliative treatment. He was about to lose yet another job, not because he was at risk for being fired, but because his lying behavior had finally boxed him into a corner. ![]() He sub-sequently described the lies as "pseu- dologia phantastica." He observed that some of his patients told lies that were so abnormal and out of proportion that they deserved a special category. ![]() The German physician, Anton Delbruck, 1 is credited with being the first to describe the concept of PL. Despite its relative obscurity, PL has been recognized and written about in the psychiatric literature for more than a century. In some cases, they might be self-incriminating or damaging, which makes the behavior even more incomprehensible. While ordinary lies are goal-directed and are told to obtain external benefit or to avoid punishment, pathological lies often appear purposeless. PL is characterized by a long history (maybe lifelong) of frequent and repeated lying for which no apparent psychological motive or external benefit can be discerned. There is, as yet, no consensus in the psychiatric community on its definition, although there is general agreement on its core elements. Pathological lying (PL) is a controversial topic.
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