Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting)
Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting) is a topic covered in the Select 5-Minute Pediatrics Topics.
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Basics
Description
- Symptoms of illness in a child that are exaggerated, fabricated, or induced by a caretaker. There is usually no underlying health disorder in the child.
- Results in harm to the child victim through repeated interactions with the medical care system, including unnecessary tests, medications, and surgeries
- Known by many names, including the following:
- “Pediatric condition falsification”
- “Caregiver-fabricated illness”
- “Medical child abuse”
- “Factitious disorder by proxy”
- All refer to harm that befalls children through the actions of a caregiver in a medical setting.
- Symptoms decrease when the child is separated from the perpetrator.
Epidemiology
- Rare, with no typical presentation. The most commonly described symptoms include apnea, seizures, factitious fevers, feeding and GI problems, failure to thrive, behavioral problems, bleeding, and sepsis.
- Presenting symptoms may present along a spectrum of severity from mild to fatal.
- Most victims are <4 years of age, but victims may often be older children.
- Males and females are equally represented.
- Symptoms may be present for years before factitious illness is considered and diagnosed.
- Morbidity is significant; cases may be fatal, especially those involving surreptitious administration of medications, poisoning, or inducing apnea.
Etiology
- The parent, most commonly the mother, exaggerates, fabricates, or induces the illnesses.
- The term Munchausen syndrome by proxy refers to specific instances where the caregiver is motivated by a desire for self-aggrandizement. As such, it only defines a subset of factitious illnesses.
- Medical providers are advised to concentrate on the specific harm done and the patient’s safety rather than on the caregiver’s motives.
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- Symptoms of illness in a child that are exaggerated, fabricated, or induced by a caretaker. There is usually no underlying health disorder in the child.
- Results in harm to the child victim through repeated interactions with the medical care system, including unnecessary tests, medications, and surgeries
- Known by many names, including the following:
- “Pediatric condition falsification”
- “Caregiver-fabricated illness”
- “Medical child abuse”
- “Factitious disorder by proxy”
- All refer to harm that befalls children through the actions of a caregiver in a medical setting.
- Symptoms decrease when the child is separated from the perpetrator.
Epidemiology
- Rare, with no typical presentation. The most commonly described symptoms include apnea, seizures, factitious fevers, feeding and GI problems, failure to thrive, behavioral problems, bleeding, and sepsis.
- Presenting symptoms may present along a spectrum of severity from mild to fatal.
- Most victims are <4 years of age, but victims may often be older children.
- Males and females are equally represented.
- Symptoms may be present for years before factitious illness is considered and diagnosed.
- Morbidity is significant; cases may be fatal, especially those involving surreptitious administration of medications, poisoning, or inducing apnea.
Etiology
- The parent, most commonly the mother, exaggerates, fabricates, or induces the illnesses.
- The term Munchausen syndrome by proxy refers to specific instances where the caregiver is motivated by a desire for self-aggrandizement. As such, it only defines a subset of factitious illnesses.
- Medical providers are advised to concentrate on the specific harm done and the patient’s safety rather than on the caregiver’s motives.
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Citation
Cabana, Michael D., editor. "Munchausen Syndrome By Proxy (Child Abuse in the Medical Setting)." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/1.3/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_.
Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting). In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/1.3/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_. Accessed March 21, 2023.
Munchausen Syndrome by Proxy (Child Abuse in the Medical Setting). (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/1.3/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_
Munchausen Syndrome By Proxy (Child Abuse in the Medical Setting) [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 March 21]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14055/1.3/Munchausen_Syndrome_by_Proxy__Child_Abuse_in_the_Medical_Setting_.
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