Diagnostic problems of unusal somatic disorder - Munchausen syndrome by proxy

Abstract

Introduction and purpose

Munchausen syndrome by proxy is a factitious disorder characterized by the search for and induction of somatic symptoms, the falsification of laboratory results, and even the mutilation of  a loved one, usually a child, by a parent or caregiver. Paediatricians often only have information about the child's condition from an interview with the child’s guardian, so it is very important to differentiate feigned disorders from real, sometimes difficult to diagnose, cases of illness. We may suspect them if the parent reports unusual symptoms in the child, insinuates further treatments and hospital stays, has above-average knowledge of medical terminology, and is aggressive towards the staff. Prominent among the causes of  Munchausen syndrome by proxy are first and foremost the desire to focus the parent/carer’s attention on themselves and the expectation of recognition for their care and concern for the child.

Methods and materials

The following review was based on articles from the PubMed and Google Scholar databases. Key search terms included munchausen syndrome, munchausen syndrome by proxy, treatment, diagnosis, paediatric condition falsification, factitious disorder.

Conclusions

Due to the nature of this disorder, physicians of different specialities may come across it during their practice. Increasing their knowledge on this topic and the effects of Munchausen syndrome by proxy will allow the correct diagnosis to be established and appropriate psychiatric therapy with psychological care to be introduced, as well as protecting children who are victims of the actions of their caregivers.