Munchausen

syndrome by proxy

Definition

This disorder can also take the form of

child abuse in which a mother makes up
illnesses for her child. This is known as
Munchausen syndrome by proxy, meaning
the mother uses the child's fake illnesses
to gain attention.

 In 95% of cases the mother is

the one abusing the child this
way; in other cases

 In time the child can come to

believe that he or she really is
sick.
Some abused children fear
contradicting their mothers, or
feel that no one will believe the
truth if they tell it.

DSM-IV
Is not officially recognized
Is generally recognized by the
psychological community.
Most often, a physical illness is
gradually induced, but in some cases
the parent claims that the child has
a psychiatric disorder instead.

Signs or Symptoms
Munchausen syndrome by proxy is quite
rare and can be difficult to diagnose.
Many of the signs, such as strange
physical symptoms in a child that seem to
come and go, can also be explained by
rare organic illnesses with which the
doctor may be unfamiliar.

 The child's symptoms do not fit a

classical picture of illness or do not
fit together well.
The child's symptoms improve at
the hospital but reappear at home.
The parent is overattentive or "too
helpful."
The parent is often involved in a
health-care field, such as nursing.

Treatment
In Munchausen syndrome by
proxy, the treatment needed is
not of the "ill" child but of his or
her mother. Parents who abuse a
child this way have a
psychological problem that
requires professional intervention

 Once the syndrome is recognized,

the child needs to be protected
and removed from direct care of
the parent. The affected parent
should not be accused directly,
but offered help.

 Because this is a form of child

abuse, the syndrome must be
reported to the authorities.
Psychiatric counseling will be
recommended for the parent
involved, but since the disorder is
rare, very little is known about
effective treatment.

Prevention
Recognition of
Munchausen syndrome by
proxy in the child-parent
relationship can prevent
continued abuse and
unnecessary, expensive,
and possibly dangerous
medical testing.