Munchausen syndrome: Encyclopedia II - Munchausen syndrome - Munchausen Syndrome by Proxy

Munchausen syndrome - Munchausen Syndrome by Proxy

In Munchausen Syndrome by Proxy (MSbP, but also known as FII, or Fabricated or Induced Illness - the official name given the condition in March 2002 by the Royal College Of Paediatrics and Child Health) [1], a caregiver, usually the mother, feigns or induces an illness in another person, usually her or his child, to gain attention and sympathy as the "worried" parent. Although MSbP cases with feigned or induced physical illness receive the most attention, it is also possible in parents who emotionally abuse their child, then claim psychiatric and/or genetic problems.

Munchausen by proxy is a term used to describe a form of child abuse and which was coined by Sir Roy Meadow, former professor of Paediatrics at the University of Leeds, England. During the 1990s and early 2000s, Meadow's expert testimony sent many parents to prison for allegedly murdering their children through MSbP, as well as causing many potential victims to be taken into care. However, during the course of 2003 a number of high-profile acquittals brought Meadow's ideas into serious disrepute. Some experts now doubt even the existence of MSbP, despite observations on hospital surveillance cameras which have caught MSbP abusers in the act. At the time of writing upwards of 250 convictions which relied on Meadow's evidence are under review. Meadow himself came under investigation by the British General Medical Council, and in July 2005 was found guilty of "serious professional misconduct".

In 2003, Sickened, an autobiographical account of the Munchausen Syndrome by Proxy abuse Julie Gregory suffered as a child, was published.

In 2003, a documentary film, MAMA/M.A.M.A., which questions the validity of Munchausen Syndrome by Proxy, arguing that in many cases doctors' overmedication of infants may be the real cause of their infirmity rather than the mother's mental illness, was released. The film contains the last interview that the controversial Sir Roy Meadow granted.

Munchausen syndrome - Clues that may indicate Munchausen Syndrome by Proxy

Caution: many of the items below are also indications of a child with a valid, but undiagnosed illness. An ethical diagnosis of MSbP must include an evaluation of the child, an evaluation of the parents and of the family dynamics. Diagnoses based only on a review of the child's medical chart are now frequently being rejected in court.

• A child who has one or more medical problems that do not respond to treatment or that follow an unusual course that is persistent, puzzling and unexplained.
• Physical or laboratory findings that are highly unusual, discrepant with history, or physically or clinically impossible.
• A parent who appears to be medically knowledgeable and/or fascinated with medical details and hospital gossip, appears to enjoy the hospital environment, and expresses interest in the details of other patients’ problems.
• A highly attentive parent who is reluctant to leave their child’s side and who themselves seems to require constant attention.
• A parent who appears to be unusually calm in the face of serious difficulties in their child’s medical course while being highly supportive and encouraging of the physician, or one who is angry, devalues staff, and demands further intervention, more procedures, second opinions, and transfers to other, more sophisticated, facilities.
• The suspected parent may work in the health care field themselves or profess interest in a health-related job.
• The signs and symptoms of a child’s illness do not occur in the parent’s absence (hospitalization and careful monitoring may be necessary to establish this causal relationship).
• A family history of similar or unexplained illness or death in a sibling.
• A parent with symptoms similar to their child’s own medical problems or an illness history that itself is puzzling and unusual.
• A suspected emotionally distant relationship between parents; the spouse often fails to visit the patient and has little contact with physicians even when the child is hospitalized with serious illness.
• A parent who reports dramatic, negative events, such as house fires, burglaries, or car accidents, that affect them and their family while their child is undergoing treatment.
• A parent who seems to have an insatiable need for adulation or who makes self-serving efforts at public acknowledgement of their abilities.

Munchausen syndrome - Prevalence by gender

It has been noted that MS and especially MSbP are disproportionately committed by females. One study showed that in over 90% of cases of Munchausen by proxy, it is the mother who is the abuser (Vennemann et al., 2005). This may be attributed to the typical socialization pattern which encourages females to seek the sympathy and assistance of others while males who do so are considered to be "weak". It is not known whether this predilection to seek sympathy also has a gender-based genetic component.

MSbP may also be attributed to another prevalent socialization pattern, that which places females in the primary caretaking role.

Adapted from the Wikipedia article "Munchausen Syndrome by Proxy", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki