Munchausen By Proxy Syndrome: The triad of abuse, self-abuse, and deception

Sigal, Mircea; Gelkopf, Marc; Meadow, Roy

doi:10.1016/0010-440x(89)90083-7

Cited by 31 publications

(18 citation statements)

References 18 publications

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“…Sigal et al (1989), who put special emphasis on the complicated relationships between perpetrator and victim and also on their interaction with the medical staff, observed that especially the older children partly showed a contribution to disorder from the very start or in the course of illness. There is a remarkable passivity concerning the perpetrator's actS.…”

Section: Discussionmentioning

confidence: 97%

Munchausen syndrome by proxy and factitious illness: Symptomatology, parent-child interaction, and psychopathology of the parents

Ammermann¹,

Klein²,

Schmidt

1995

European Child & Adolescent Psychiatry

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The term Munchausen syndrome by proxy is used to diagnose children presenting symptoms of an organic disorder resulting from manipulations initiated by their caretakers. Even in early infancy it happens that injuries are induced, and that drugs, poisons or medicine are administered in order to provoke and feign clinical symptoms of severe diseases. Exact data on prevalence are not available but it is obvious that Munchausen syndrome by proxy is a rare psychiatric disorder. There is a body of evidence that Munchausen syndrome by proxy is nothing but the extreme of a broader clinical entity for which the term factitious illness has been introduced. In this group children are included whose mothers invent a history of disease in order to produce symptoms without actually damaging their children. It is not well established whether such a distinction is necessary and whether there are differences in long-term outcome. Onset of symptoms is as early as three weeks up to twelve years, and mean age of diagnosis according to a more comprehensive study is 3 1/4 year. The estimated mortality rate of children with Munchausen syndrome by proxy is 9 percent. In three of the four cases of children reported here clinical presentations were dominated by symptoms of central nervous disorders. All mothers showed unsure and inconsistent parental behaviour and inefficient coping. None of them received support from their partners, if present. In interaction the children always wanted to dominate their mothers. The high amount of personality disorders observed in the caretakers might be the reason for the often reported failure of psychotherapeutic interventions.

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Section: Discussionmentioning

confidence: 97%

Munchausen syndrome by proxy and factitious illness: Symptomatology, parent-child interaction, and psychopathology of the parents

Ammermann¹,

Klein²,

Schmidt

1995

European Child & Adolescent Psychiatry

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“…The incidence of MSP was reported to be 0.5/100,000 in children <16 years of age in the UK [8] , but there is no published incidence for Turkey. In MSP, unnecessary procedures and treatments are usually administered to a child by an adult to treat a factitious illness [9] . This syndrome is a form of child abuse in which adults, usually the mother, create an illness in their child [7] .…”

Section: Discussionmentioning

confidence: 99%

A Rare Reason of Hyperinsulinism: Munchausen Syndrome by Proxy

Akın¹,

Yeşilkaya²,

Sarı³

et al. 2016

Horm Res Paediatr

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Hyperinsulinism, one of the most important causes of hypoglycaemia, can be congenital or acquired. Rarely, drug toxicity can be a reason for hyperinsulinism. In the context of Munchausen syndrome by proxy (MSP), toxicity usually occurs in children due to drug administration by a parent or caregiver. A 7-year-old girl was referred to our department due to a hyperglycaemic period and hypoglycaemic episodes. On admission, gliclazide was initiated due to her hyperglycaemia, which we attributed to maturity onset diabetes of the young. However, during follow-up, hypoglycaemic levels were detected. Despite cessation of gliclazide, hypoglycaemic seizures occurred. Even with the medications administered, hypoglycaemia could not be prevented. During follow-up, the mother's affect, characterized by anxiety and interest in her daughter's medical care, appeared discordant with the situation. Due to our suspicion of MSP, we discovered toxic levels of gliclazide in the blood and urine samples which had been sent to the toxicology laboratory to search for hypoglycaemic agents. The patient was isolated, and all medications were stopped. After isolation, her hypoglycaemia disappeared, and she became hyperglycaemic (250 mg/dl). Physicians should consider the possibility of MSP in hyperinsulinaemic patients with discordant laboratory results and clinical symptoms, even if the child's parents display great concern.

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“…Sie schwanken zwischen heftigen Gefühlen von Schuld und Unschuld, Hass und Selbsthass sowie wechselnden Impulsen von Selbstbestrafung und Bestrafung anderer. Es spricht einiges dafür, dass bei Müttern mit einer derartigen oder ähnlichen Struktur die hieraus resultierenden innerpsychischen Spannungen zeitweise im symbiotisch manipulativen Umgang mit dem Kind nach außen verlagert werden können, was vorübergehend zu einer innerpsychischen Entlastung und Spannungslinderung führt [2,3,13,25].…”

Section: Verstehensversucheunclassified

“…Auch wenn sich die Beweislage für ein Münchhausen-byproxy-Syndrom zunehmend verdichten und erhärten sollte, bedarf es eines hohen Maßes an Selbstreflexion und ggf. eines professionellen Akzeptierens der schweren Kränkung und der häufig auftretenden Schamgefühle, dass man möglicherweise als Behandler selbst wiederholt Opfer der Täuschungen wurde und an der Schädigung des Kindes mitgewirkt hat [2,7,13,25].…”

Section: Die Verführung Der Mediziner Zur Kindesmisshandlungunclassified

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Wenn Mediziner ungewollt zur Kindesmisshandlung verführt werden: Münchhausen-by-proxy-Syndrom

Krupinski¹

2006

Wien Med Wochenschr

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Reports on seemingly caring mothers, who at the same time fabricate or provoke clinical symptoms in their children and subsequently expose them to potentially harmful medical procedures, are hardly believable at first sight. Nevertheless the steadily growing number of reports on this kind of child abuse, known as Munchausen-by-proxy syndrome, points to a significant number of undetected cases. The interactional involvement of health care professionals in the abuse tends to impede diagnosis, and, as a consequence of the syndrome, usually leads to violent emotional reactions, which require careful analysis and professional handling.

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Munchausen By Proxy Syndrome: The triad of abuse, self-abuse, and deception

Cited by 31 publications

References 18 publications

Munchausen syndrome by proxy and factitious illness: Symptomatology, parent-child interaction, and psychopathology of the parents

Munchausen syndrome by proxy and factitious illness: Symptomatology, parent-child interaction, and psychopathology of the parents

A Rare Reason of Hyperinsulinism: Munchausen Syndrome by Proxy

Wenn Mediziner ungewollt zur Kindesmisshandlung verführt werden: Münchhausen-by-proxy-Syndrom

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