Monday, June 17, 2013

Munchausen Syndrome by Proxy: Causes, Symptoms & Diagnosis

Munchausen Syndrome by proxy, also known as MSBP, is one type of mental illness that causes an individual to lie about disease in a person under his or her care. The syndrome is named after Baron von Munchausen - an 18th-century German dignitary known for telling strange stories about his travel experiences simply to seek attention. And the term ‘by proxy’ specifies that a person is simulating or exaggerating symptoms in any other person and not in himself or herself. The worst part of this disease is that victims are mostly children and that’s why this disease is also referred to as a form of child abuse. In most cases (95%), MSBP occurs with mothers whereas in some rare cases a father, grandparent or even a babysitter may abuse the child in this absurd manner.

Munchausen Syndrome by Proxy: Causes, Symptoms & Diagnosis

Individuals with MSBP purposely harm or describe fake symptoms in their children just to get the sympathy and special attention given to the family of someone who is sick. MSBP sufferers might exaggerate the child’s symptoms in many ways, for example - they might alter diagnostic test results by contaminating urine or stool sample, falsify medical records, etc. And in the worst cases, a parent may also try to induce real symptoms of a disease in his/her child through various means like poisoning, starving, suffocating and causing infection.

MSBP is certainly a serious condition and requires immediate medical treatment as this disorder can lead to severe short term as well as long term complications, including frequent hospitalizations and even death of the victim. Now, go through the article given below to learn about Munchausen Syndrome by proxy causes, symptoms and treatments.

What causes MSBP?
The exact cause of MSBP is still unknown. However, according to researchers, both biological and psychological factors play an important role in the development of this illness. Some theories imply that people who were abused or neglected as children or those who had experienced the early loss of a parent are more likely to develop this disorder. Other two common factors that may incline a person to MSBP include a serious disorder in childhood or an existing personality disorder. Some research even indicates that severe stress (such as marital problems) can also trigger the MSBP disorder in an individual.

Warning signs of MSBP

According to the health experts, any of the warning signs mentioned below may point towards the likelihood that MSBP disorder is a factor in a child’s apparent illness:
  • Disease that continue in spite of traditionally effective treatments
  • The child has been taken to several doctors without receiving a clear medical diagnosis
  • The parent is extremely reluctant to leave the child’s side and is overattentive
  • The parent seems very keen for the child to undergo additional treatments, tests or even surgeries
  • The parent has a health-care background
  • Another child in the same family has/had mysterious illness or death
  • The symptoms may get worse only when the parent is present nearby the child, while it may improve when the suspected caretaker is absent
  • Symptoms are such that do not make any medical sense
  • The victim continuously fails to respond to therapy
  • The parent appears to have close relationship with the medical staff of a hospital
  • A family history of SIDS (Sudden Infant Death Syndrome)
  • A caregiver who has a history of MS (Munchausen Syndrome)
  • Blood in lab sample do not match with the child’s blood
  • Signs of chemicals found in the child’s blood, urine or stool sample
  • The other parent is not involved in the child’s treatment, even if the child’s condition is worse
Now, following points would depict the profile of a typical MSBP perpetrator:
  • Are most often upper-class and well-educated persons
  • Seems to be enormously knowledgeable about the victim’s illness
  • Appears quite concerned (sometimes over-concerned) about the child or the victim
  • Prevents the victim from participating in outdoor activities
  • A history of marital conflict
  • Feeling alone and isolated
  • Strange involvement in the victim’s care, to the point where he/she tries to exclude medical staff
  • A history of Munchausen syndrome and/or suicide attempts
  • Very friendly with medical and nursing staff
  • May falsely report that the child has fever, bleeding, diarrhea, mental depression, skin rashes or trouble breathing
How is Munchausen syndrome by proxy diagnosed?

The diagnosis of this condition is very difficult. The child, who is victimized by MSBP, typically has a history of several diseases and even multiple surgeries. However, at the same time, the caretaker usually appears as a devoted & caring parent, and hence any clue of abuse is hardly seen. Therefore in order to diagnose this disorder, sometimes a fully detailed medical history from other family members, friends or relatives will be required. Plus, the child is checked for signs of any physical abuse. Besides this, the following may also be required:

Documentation: This method is all about noting down how the child reacts when he/she is with the caretaker.

Separation: The child may be separated from the caretaker for sometime. Once separated, the child’s condition as well as the behavior is closely observed. By doing so will help diagnose the condition, if the child shows improvement without any treatment.

Video monitoring: In this method, a video footage is recorded to check the behavior of the caretaker when left alone with the child. This footage can even act as a strong evidence of abuse.

How is MSBP treated?

Children victimized by sufferers of MSBP can have severe complications from injuries, medications, infections or tests. Moreover, risk for psychological complications such as depression, post-traumatic stress disorder, anxiety, etc. will be also increased in them. Hence, once the syndrome is recognized, it’s very important to remove that child from direct care of the parent immediately. Such children must be placed in a special home or day care center.

Complete treatment of people with MSBP is quite difficult since they often resist treatment or deny that there is a problem. No doubt, certain psychiatric medications such as antidepressants, mood stabilizer and anti-anxiety medications can help ease some of the symptoms in perpetrator or the victim but in no way these medications can cure the disease completely.

Individual psychotherapy (a type of counseling) for the patient of MSBP, the victim, as well as for the family members, is often included in the treatment program. Even after the treatment, there are chances that the patient may repeat his/her behavior. So, counselors, doctors, and most importantly family members must closely watch how the caretaker is interacting with her children.


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