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Child Abuse

Maunchasen by Proxy and Abuse

10/04/2000

Question:

what is maunchasen by proxy? I might have the spelling wrong. This is supposed to deal with a person that does harm to another person and then becomes the person that saves the person just in time. I have this situation with a mother and son.

Answer:

Munchausen syndrome by proxy is a rare form of child abuse in which illness in a child is simulated (faked) and/or produced by the child`s caregiver, often the mother. The illness often results in extensive medical evaluations in the child, with multiple and lengthy hospitalizations, a wide variety of tests, and consultation with many different physicians and hospitals. The child`s caregiver denies any knowledge about the cause of the child`s illness, but the acute symptoms and signs in the child often go away when the child is separated from the caregiver. The diagnosis of Munchausen syndrome by proxy is extremely difficult to make. The caregiver`s history often sounds "real" to the physician, leading the physician to believe there is a serious illness, thus perpetuating more tests, more evaluations, more hospitalizations, etc. When considering this diagnosis in a patient, it is important to involve a multidisciplinary team with both medical and non-medical personnel early on with experience in evaluating these cases and making the diagnosis.

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Response by:

Stephanie Zimmerman, MD
Fomerly, Fellow
College of Medicine
University of Cincinnati