Mental Health: Munchausen Syndrome By Proxy

People with MSP may create or exaggerate the child's symptoms in several ways. They may simply lie about symptoms, alter tests (such as contaminating a urine sample), falsify medical records or they may actually induce symptoms through various means, such as poisoning, suffocating, starving and causing infection.

What Are the Symptoms of Munchausen Syndrome By Proxy?

Certain characteristics are common in a person with MSP, including:

• Is a parent, usually a mother.
• May be a healthcare professional.
• Is very friendly and cooperative with the healthcare providers.
• Appears quite concerned (some may seem overly concerned) about their child.
• May suffer from Munchausen syndrome (a related disorder in which a person repeatedly acts as if he or she has a physical or mental illness when he or she is not really sick).

Other possible warning signs of MSP include:

• The child has a history of many hospitalizations, often with a strange set of symptoms.
• Worsening of the child's symptoms generally is reported by the mother and is not witnessed by the hospital staff.
• The child's reported condition and symptoms do not agree with the results of tests.
• There may be more than one unusual illness or death of children in the family.
• The child's condition improves in the hospital, but symptoms recur when the child returns home.
• Blood in lab samples may not match the blood of the child.
• There may be signs of chemicals in the child's blood, stool or urine.

What Causes Munchausen Syndrome By Proxy?

The exact cause of MSP is not known, but researchers are looking at the roles of biological and psychological factors in its development. Some theories suggest that a history of abuse or neglect as a child, or the early loss of a parent may be factors in its development. Some evidence suggests that major stress, such as marital problems, can trigger MSP.

How Common Is Munchausen Syndrome By Proxy?

There are no reliable statistics regarding the number of people in the U.S. who suffer from MSP, and it is difficult to assess how common the disorder is because many cases go undetected.

How Is Munchausen Syndrome By Proxy Diagnosed?

Diagnosing MSP is very difficult because of the dishonesty that is involved. Doctors must rule out any possible physical illness as the cause of the child's symptoms before a diagnosis of MSP can be made.

If a physical cause of the symptoms is not found, a thorough review of the child's medical history, as well as a review of the family history and the mother's medical history (many have Munchausen syndrome themselves) may provide clues to suggest MSP. Remember, it is the adult, not the child, who is diagnosed with MSP.

How Is Munchausen Syndrome By Proxy Treated?

The first concern in MSP is to ensure the safety and protection of any real or potential victims. This may require that the child be placed in the care of another. In fact, managing a case involving MSP often requires a team that includes a social worker, foster care organizations and law enforcement, as well as doctors.