The incidence of MSBP is about 0.4/100,000 in children younger than 16 years of age and 2/100,000 in children younger than the age of 1 year. In one large study, the mean age at diagnosis was 20 months. Siblings of child victims of MSBP also frequently are abused; one series found a rate of 40% of abuse in siblings, and 18% had a history of sibling death.
In Munchausen Syndrome by Proxy, an individual falsifies or induces illness in another person to accrue emotional satisfaction—but this time vicariously. This is a form of maltreatment (abuse and/or neglect) rather than a mental disorder. Children are the usual victims and the mother is the usual perpetrator. MBP is sometimes called "Fabricated or Induced Illness by Carer" (FII)
The term "Munchausen Syndrome by Proxy" was coined to describe a form of child abuse in which a caregiver, usually the mother, feigns or induces symptoms in a child that result in unnecessary medical testing and procedures. Classically, the motivation for the behavior is to assume a "sick role" through the child, thereby engaging in an ongoing relationship with medical personnel. The syndrome was identified by Meadow, who reported two cases in 1977.
Munchausen syndrom by proxy (MSBP) is characterized by four features: 1) a parent or other caregiver fabricates an illness; 2) the child is presented persistently for medical assessment, often resulting in multiple procedures; 3) the perpetrator denies the cause of the child's illness; and 4) acute symptoms and signs of the illness stop when the child and perpetrator are separated. Although boys and girls are equally likely to be victims of MSBP, the condition is seen more commonly in younger children.
Munchausen by Proxy Syndrome is quite possibly one of the most difficult disorders to diagnose. For this reason, an unfortunate nine percent of victims to this abuse die (Feldman, 1998, p. 1). Indicators that a parent may be suffering from Munchausen by Proxy Syndrome include but are not limited to a discrepancy between the child’s medical records and what actually seems logical to have happened, the child exhibiting symptoms that do not respond to treatment as they were expected to, an illness that only appears or becomes more grave in the presence of the parent, symptoms that disappear in the absence of the perpetrating parent, sickness that resumes once the caretaker is informed that the child is recovering, or similar symptoms found in siblings or family members of the victim (Lasher, 2004, p.1).
Munchausen by Proxy Syndrome (MBPS), the origin of its name, the subtypes of the disorder, the symptoms associated with it, the dynamic relationship between the sufferer of the disorder and the physicians caring for the sufferer’s child, the causes of this syndrome, and the suggested treatment for it. MBPS is extremely difficult to diagnose, which is why many children die before doctors realize what was actually happening to them. Treatment for this disorder is limited, as well as knowledge and understanding of its causes. For this reason, it is extremely important to raise awareness of Munchausen by Proxy Syndrome and to work towards ensuring that no more children fall victim to illness and death at the hands of their own parents.
People with factitious disorder and Munchausen syndrome feign, exaggerate, or actually self-induce illnesses. Their aim? To assume the status of “patient,” and thereby to win attention, nurturance, and lenience from professionals or nonprofessionals that they feel unable to obtain in any other way. Unlike individuals who engage in malingering, people with factitious disorder and Munchausen syndrome are not primarily seeking external gains such as disability payments or narcotic drugs—though they may receive them nonetheless. In some cases, the fabrication or induction of illness is an expression of jealousy, rage, or the desire to control others.
Once MSBP is considered, the American Academy of Pediatrics Committee on Child Abuse and Neglect recommends working with multidisciplinary child protection team, including state social service agencies and, ideally, a pediatrician who has expertise in child abuse to assess the case. As part of the assessment, physicians should ensure communication and cooperation among all treating physicians and review all medical charts pertinent to the child's care, recognizing that abusing parents often seek medical care from a variety of sources and may change physicians frequently. It also is important to involve the entire family in treatment and address ongoing family in treatment and address ongoing family issues to ensure the future safety of the affected child and other children in the home.
The sentencing of those with MSBP who have committed serious crimes is particularly difficult. It has much in common with the sentencing of those with antisocial personality disorder or psychopathy, and who are similarly not readily amenable to psychiatric or psychological intervention, either pharmacotherapeutic or cognitive-behavioral.
Children who are victims of MSBP can have lifelong physical and emotional problems and may have Munchausen syndrome as adults. This is a disorder in which a person causes or reports his or her own symptoms.
Doctors aren't sure what causes it, but it may be linked to problems during the abuser's childhood. Abusers often feel like their life is out of control. They often have poor self-esteem and can't deal with stress or anxiety.