Munchausen Syndrome by Proxy

What is Munchausen syndrome by proxy?

Munchausen syndrome by proxy (MSBP) is a mental disorder. People with Munchausen syndrome cause illness to get sympathy and medical care. The term “by proxy” means that they cause illness in others. Victims may be children too young to talk or understand what the person with MSBP is doing to them. Victims may also be elderly or disabled.

How does it occur?

The exact cause of this disorder is not known. The disorder is most common in people who:

• have a grudge against healthcare providers
• have another mental disorder
• have few long-term relationships and an unsatisfying family life
• received a lot of medical care for real physical problems as children
• were abused as children

People with MSBP may feel insecure, uncertain, lonely, and depressed. A mother may believe that the ill child will bring a closer relationship with the spouse.

What are the symptoms?

Over 90% of people with MSBP are mothers. However, fathers, day care providers, and healthcare professionals may also have this disorder. Some signs of MBSP include:

• The child's problem is very rare and dramatic.
• The child's problems begin when the mother is with the child. The problems go away when the child is separated from the mother.
• The child's problems do not respond to treatment. No clear diagnosis can be found.
• The mother appears to be unusually calm and very eager to have the child undergo tests and surgery.
• The mother does not want to leave her child's side.
• The mother herself seems to need constant attention.
• The mother falsely accuses others of wrongdoing.
• The mother knows a lot about medicine and hospitals.
• The mother has symptoms similar to her child's medical problems, or she has a medical history of puzzling and unusual problems for herself or a history of self-harm.
• The mother lies or makes up problems or dramatic events such as house fires or car accidents.
• The mother often seems devoted and attentive to the point of being overprotective or obsessed with the child's illness.
• There is a family history of other children with unexplained illness or deaths.

How is it diagnosed?

Diagnosis is very difficult because dishonesty is a part of this disorder. MSBP is usually diagnosed by gathering evidence, such as filming the person abusing the victim in a hospital room.

How is it treated?

The main goal is to protect potential victims. Once this goal is met, MSBP may be treated with psychotherapy.

Cognitive-behavior therapy (CBT) may help identify and change views the person has of herself, the world, and the future. This therapy helps the person recognize unhealthy ways of thinking. Family therapy may help families to better understand the person with MSBP and their need for attention.

There are no medicines to treat this disorder. However, medicine may help treat depression or anxiety that may go along with MSBP.

When should I seek help?

Many people with this disorder do not get help until they are caught by the police. This disorder results in pain, torture, or death for the victims of the person with MBSP.

If you suspect that someone you know has MSBP, get help right away. If you're not sure who to call, look in the front of your phone book for listings under child abuse, Department of Social Services, or Department of Human Services. You can also call your local law enforcement agency if you think the victim is in immediate danger.

For more information, contact:

• National Alliance for the Mentally Ill (NAMI)
  Phone: 1-800-950-NAMI
  Web site: http://www.nami.org
• Mental Health America
  Phone: 1-800-969-6642
  Web site: http://www.mentalhealthamerica.net