Thread: Munchausen By Proxy Syndrome

Hello
I'm wondering if there is a theraphy for MPS that guarantees for a 80% of patient mothers, that they'll be able to back to home?.

How the childs can feel sure that their mothers will not try to poison them again?

Most cases of Munchausen by proxy are simply lousy diagnosis. It is a very, very rare illness. Some experts believe it does not exist at all. However, young children are often mistreated, and a MBP diagnosis can be very convenient.

Skeptic's right.

Just look at the whole number of children who are abused by their parents. It's more common than we'd like to think.

Then look at the explanations (excuses are hard to come by). We have intellectual disability as the prime one where some people really don't understand that what they're doing is harmful. Then we have alcohol or drug affected parents who find themselves unable to control their own behaviour. Occasionally there are parents with florid psychosis who sincerely believe the child is a demon or some other frightening thing - these children are more often killed rather than simply injured. And we have other neurotic, psychotic and mental illnesses or brain injuries - the most common with small babies is of course, post natal depression (which also affects some men apparently).

Munchausen by proxy is one of the rarest conditions within that mental illness subset. And they don't just use poison, they do all kinds of horrible things.

And the largest group is people who weren't well brought up themselves or who are so poorly socialised they don't meet basic requirements for ordinary decent behaviour. It's absolutely true that an inconsolable baby can drive you to distraction - but you can kick a chair or punch the wall rather than the baby.

For health care staff, and especially social workers, the biggest problem is having enough time to devote to supervising dysfunctional families until they've demonstrated real capacity to handle the child safely at home. And a Munchausen by proxy diagnosis requires close supervision for quite a while, and reducing oversight once safety has been demonstrated. The main thing would be ensuring the parent sticks to the medication and counselling routine for their own psychiatric therapy.

The Munchausen diseases are indeed very rare and hard to distinguish from intentional actions. In my 30 year professional career I have seen one clear case of Munchausens disease and no more than 3 cases of Munchausen by proxy.

One case particularly comes to mind. A person came into our ER complaining of amnesia, unable to identify himself and inadaquately dressed. We admitted him, treated him and believed we had stablized him and provided him with clothing, and referrals to out patient services. A week after discharge we saw an article in the local paper about about a man with amnesia, and no id being brought to another area hospital. The article discribed the clothing he was wearing and we recognized it as the clothing we had given him the week before. Simple amnesia or a feuge state were ruled out by the absence of any identifying papers. He had left us with plenty of id. He had gotten rid of that before presenting at the next hospital but he was still wearing the clothing we gave him. So is this malingering or Munchausen's? He did not present asking for controled drugs and his amnesia seemed convining to professionals. Patient confidentiality rules prevented us from consulting with the other facility.