Munchausen syndrome By proxy

1
Munchausen syndromeBy proxy
2
Munchausens Syndrome

• Recognized as a psychiatric disorder in 1951 by
  the American Psychiatric Associations Diagnostic
  and Statistical Manual of Disorders as the
  intentional production of physical symptoms.

3
Munchausen Syndrome By Proxy, 1976

• MSBP was coined after a report describing four
  children who were so severely abused that they
  were dwarfed.

4
MSBP, 1977

• A less extreme form of child abuse was described
  in which mothers deliberately induced or falsely
  reported illnesses in their children.

5
MSBP

• Most victims are children
• Perpetrators are almost always parents or parent
  substitutes
• Once victims are hospitalized, they may be
  subjected to multiple and dangerous diagnostic
  procedures that invariably produce negative and
  confounding results.

6
MSBP

• When the victim and abuser are separated, the
  victims symptoms cease.
• When confronted, the abuser usually denies
  knowledge of how the childs illness occurred.

7
Case Study 1

• Follow-Up
• Mother pled guilty to felonious, third-degree
  assault. She stated The only time I ever
  caused my son to stop breathing was in the
  hospital. She received 3 years probation during
  which she was to received psychotherapy.

8
Case Study 1

• Conclusion
• The child had no further apnea, and at 24 months
  of age, he was healthy and normal. Eventually,
  the family was reunited.

9
Case Study 2

• Father was taken to jail and admitted to
  smothering his daughter after seeing the video.
  He was charged with felonious, third-degree
  assault and got 10 months and then 5 years
  probation, no contact with daughter in future and
  no unsupervised with any child in the future.

10
Case Study 3

• Child was removed from the home has remained
  healthy since that time. Assault charged were
  pressed against the mother but she continues to
  deny any wrong-doing. The case is still pending.

11
Conclusion

• MSBP is not rare and is resistant to parental
  psychotherapy
• 10 of all MSBP victims die

12
Help For Investigators

• Review victims medical records
• Compile a social history of the family, including
  deaths, injuries and illnesses
• Interview family, neighbors, babysitters
• Use video surveillance in the hospital
• Search family residence for evidence of assaults

13
Warning Signs

• Unexplained, prolonged illnesses so extraordinary
  that doctors remark theyve never seen anything
  like it before.
• Repeat hospitalizations and medical evaluations
  without definitive diagnosis.
• Mothers who are not as concerned as the medical
  staff, comfortable on childrens ward, close
  relationships with staff

14
Warning Signs

• Families with sudden, unexplained infant deaths
  and several members have alleged serious medical
  disorders.
• Mothers with previous medical experience and
  similar medical history to child.
• Increased parental uneasiness as child recovers
  or approaches discharge.