Munchausen syndrome by proxy: Diagnosis and prevalence.

Abstract

A review of the literature and a survey of pediatric neurologists and gastroenterologists yield data indicating that the prevalence of Munchausen syndrome by proxy is greater than is generally estimated. This possibility is further supported by follow-up data on siblings of victims, together with wide variability among practitioners in case identification.

Monsters in the Closet: Munchausen Syndrome by Proxy

“…14 Surveys of pediatric neurologists and gastroenterologists suggest that the condition may be much more common than previously appreciated and that many cases probably go undiagnosed. 15 …”

“…Schreier and Libow 15 describe the complex relationship with the MSbP abuser as "a perverse sadomasochistic relationship with the pediatrician, the infant serving as an object in the service of controlling the physician." dren by establishing an organic cause of illness.…”

“…27 Even when they are not actively involved in the abuse, several authors have described the fathers or male guardians of MSbP victims as being distant, emotionally disengaged, and powerless. 15,30,31 These men play a passive role in MSbP by being frequently absent from the home and rarely visiting the hospitalized child. Such men will vehemently deny the possibility of abuse, even in the face of overwhelming evidence or their child's pleas for help.…”

“…15 • Abusers may abscond with the child if they detect suspicion. Several features distinguish the victims and perpetrators of MSbP from those involved in more typical physical abuse behaviors (Table 4).…”

“…15 It is a very serious form of child abuse with high recidivism and mortality rates. 31 Prognosis is extremely poor if the child is left in the home.…”