Munchhousen's by proxy (MSP) is now known as a fictitious disorder imposed on another (FDIA). I've seen real life examples of this. A parent or caregiver can be unhappy, and they induce or exaggerate symptoms in another person to generate sympathy or take out their negative emotions on that person. It's very hard to catch. It was first published on in 1951.
Munchhousen's tends to generate high health care costs and unnecessary procedures. It is underdiagnosed because it is not well known and there is a high rate of countertransference. Patients with Munchhousen's have high mortality rates due to symptoms imposed on self and others.
The term was introduced by someone named Asher to describe individuals who intentionally produce signs and symptoms of a disease and who tend to seek medical or hospital care.
In 1977, Meadow used the term “Munchausen syndrome by proxy” to describe children whose mothers produce histories of illness to their children and who support such histories by fabricated physical signs and symptoms, or even by alter laboratory tests. This term is also used to refer to elderly or disabled person and/or dependent adults who signs or physical symptoms are created by a caregiver and whose laboratory tests were altered.
Munchausen syndrome has sometimes been referred to as “hospital addiction”, “polysurgical addiction,” or “professional patient syndrome".
The problem lies closer to home. These people may not be aware of the patterns. The hospital systems waste money on diagnostic bullshit and overmedicalization. DSM vagueness. Perfectionism in medicine.
FDIA is a relatively rare behavioral disorder. It affects a primary caretaker. The person with MSP gains attention by seeking medical help for exaggerated or made-up symptoms of someone in their care. As healthcare providers strive to identify what's causing the child's symptoms, the deliberate actions of the parent or caretaker can often make the symptoms worse.
The person with MSP does not seem to be motivated by a desire for any type of material gain. While healthcare providers are often unable to identify the specific cause of the child's illness, they may not suspect the parent or caretaker of doing anything to harm the child. In fact, the caregiver often appears to be very loving and caring and extremely distraught over their child's illness.
People with MSP may create or exaggerate a child's symptoms in several ways. They may simply lie about symptoms, alter tests (such as contaminating a urine sample), falsify medical records, or they may actually induce symptoms through various means, such as poisoning, suffocating, starving, and causing infection.
People with MSP are often health care professionals and are usually very friendly and cooperative with providers. They demonstrate a great deal of concern and may have Munchausen syndrome, a disorder in which they repeatedly act sick when they do not actually have any physical illness.
Possible warning signs of MSP The child has a history of many hospitalizations, often with a strange set of symptoms, the symptoms get worse outside of treatment settings, the symptoms are reported worse by the caregiver then the patient, the symptoms don't agree with the testing, the family has a history of unusual illness, samples do not match the genetics of the patient, or chemicals appear in the bodily fluids of the patient.
The exact causes of MSP are not known. Researchers are looking at the roles of biological and psychological factors in its development. A history of abuse or neglect as a child or the early loss of a parent may be factors in its development. Some evidence suggests that major stress, such as marital problems, can trigger MSP.
Diagnosing MSP is very difficult because of the dishonesty that is involved. Doctors must rule out any possible physical illness as the cause of the dependent's symptoms before a diagnosis of MSP can be made. A thorough review of the child's medical history, as well as a review of the family history and the parent's medical history may provide clues to suggest MSP.
The first concern in MSP treatment is to ensure the safety and protection of any real or potential victims. This may require that the child be placed in the care of another. In fact, managing a case involving MSP often requires a team that includes a social worker, foster care organizations, and law enforcement, as well as doctors.
Successful treatment of people with MSP is difficult because those with the disorder often deny there is a problem. In addition, treatment success is dependent on the person telling the truth, and people with MSP tend to be such accomplished liars that they begin to have trouble telling fact from fiction.
Psychotherapy (a type of counseling) generally focuses on changing the thinking and behavior of the individual with the disorder (cognitive-behavioral therapy). The goal of therapy for MSP is to help the person identify the thoughts and feelings that are contributing to the behavior, and to learn to form relationships that are not associated with being ill.
This disorder can lead to serious short- and long-term complications, including continued abuse, multiple hospitalizations, and the death of the victim. (Research suggests that the death rate for victims of MSP is about 10%.) In some situations, a child victim of MSP learns to relate getting attention to being sick and develops Munchausen syndrome themselves.
