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Munchausen Syndrome By Proxy

Munchausen syndrome by proxy (MSP) -- or Munchausen by proxy -- is a psychological disorder marked by attention-seeking behavior by a caregiver through those who are in their care.

MSP is a relatively rare behavioral disorder. It affects a primary caretaker, often the mother. The person with MSP gains attention by seeking medical help for exaggerated or made-up symptoms of a child in his or her care. As health care providers strive to identify what's causing the child's symptoms, the deliberate actions of the mother or caretaker can often make the symptoms worse.

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The person with MSP does not seem to be motivated by a desire for any type of material gain. While health care providers are often unable to identify the specific cause of the child's illness, they may not suspect the mother or caretaker of doing anything to harm the child. In fact the caregiver often appears to be very loving and caring and extremely distraught over her child's illness.

People with MSP may create or exaggerate a 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 or caregiver, usually a mother
  • May be a health care professional
  • Is very friendly and cooperative with the health care 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.

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