Interesting article in the New York Times about one example of a guy who compulsively lies, as a mental health type problem that he recognises. I will gift the link, but here are some interesting parts:
In 1891, the German psychiatrist Anton Delbrück coined the term pseudologia fantastica to describe a group of patients who, to impress others, concocted outlandish fabrications that cast them as heroes or victims.
That argument is advanced in a new book by the psychologists Drew A. Curtis and Christian L. Hart, who propose adding a new diagnosis, Pathological Lying, to the Diagnostic and Statistical Manual of Mental Disorders.
Psychiatry, they argue, has long misidentified this subset of patients. Rather than “dark, exploitative, calculating monsters,” they argue, pathological liars are “often suffering from their own behavior and unable to change on their own.” These liars, the psychologists argue, could benefit from behavioral therapies that have worked with stuttering, nail-biting and trichotillomania, a hair-pulling disorder....
Just before his fabrications were exposed, Mr. Massimine checked into a psychiatric hospital, where he was diagnosed with a cluster B personality disorder, a syndrome which can feature deception and attention-seeking. For many of the people close to him, a diagnosis made all the difference.
More generally on the topic:
In 2010, when researchers from Michigan State University set out to calculate how often Americans lied, they found that the distribution was extremely skewed.
Sixty percent of respondents reported telling no lies at all in the preceding 24 hours; another 24 percent reported telling one or two. But the overall average was 1.65 because, it turned out, a small group of people lied a lot.
This “small group of prolific liars,” as the researchers termed it, constituted around 5.3 percent of the population but told half the reported lies, an average of 15 per day. Some were in professions, like retail or politics, that compelled them to lie. But others lied in a way that had no clear rationale.
This was the group that interested Dr. Curtis and Dr. Hart. Unlike earlier researchers, who had gathered data from a criminal population, the two psychologists set about finding liars in the general public, recruiting from online mental health forums. From this group — found “in mundane, everyday corners of life,” as Dr. Hart put it — they pieced together a psychological profile.
These liars were, as a whole, needy and eager for social approval. When their lies were discovered, they lost friends or jobs, which was painful. One thing they did not have, for the most part, was criminal history or legal problems. On the contrary, many were plagued by guilt and remorse. “I know my lying is toxic, and I am trying to get help,” one said.
This profile did not line up with the usual psychiatric view of liars, who are often diagnosed with Antisocial Personality Disorder, a group seen as manipulative and calculating. This misidentification, the authors argue, has led to a lack of research into treatments and a general pessimism that habitual liars are capable of change.