Munchausen’s Syndrome by Proxy: Symptoms and Causes

This strange mental disorder makes the person pretend to take care of a fake sick person, manipulating him/her.

Unfortunately, many children are abused every day in our society. There are several forms of child abuse and multiple classifications. In general terms, we can define the following types of abuse: physical, psychological, sexual and neglect.

In 2002, an epidemiological study was carried out in Spain which confirmed the existence of 11,148 minors who were victims of abuse in the family environment. Of these children, 86.37% suffered from neglect, 35.38% from psychological abuse, 19.91% from physical abuse and 3.55% from sexual abuse..

However, as in almost any epidemiological study, there are "submerged" data and only the tip of the iceberg can be glimpsed. In this article we are going to talk about a form of child maltreatment that is very difficult to diagnose, we could even call it "hidden child maltreatment": Munchausen's Syndrome by Proxy..

What is Munchausen syndrome by Proxy?

Munchausen syndrome by proxy (MPS), or according to the DSM-5 Factitious Disorder as applied to another, is a particular form of high-risk child maltreatment that is difficult to diagnose because it often goes undetected for a long time, even years. It is a syndrome that has seen its incidence increase due to greater knowledge and due to increased knowledge and professional awareness.

According to the DSM-5, it is a disorder characterized by the falsification of physical or psychological signs or symptoms, or induction of injury or illness, in another, associated with deception. It is a mental disorder that is typically typically seen in adults who are in the care of others who are dependent on them (usually helpless), which (generally helpless, which has its logic). The victims of this disorder are often minors, and it is considered a form of child abuse.

The child's parents (usually, according to epidemiological studies on the subject, the mother) simulate the existence of illnesses or provoke symptoms in the minor in order to receive medical care, some of which is very risky and costly. It seems that one of the objectives of the parent is to deceitfully present their child to others as a sick, vulnerable, dysfunctional and/or troubled person.

Experts in the study of this disorder state that the parent continues the deception even without receiving any visible benefit or reward in return.. The most serious consequences of this syndrome are severe physical and psychological complications for the child and, ultimately, death.

Symptoms and signs

The symptoms or signs are usually incoherent, often unexplained, and resistant to treatment.The symptoms or signs are usually incoherent, often unexplained, and resistant to treatment, as they are deliberately and recurrently executed by the parent. Examples include:

• Repeated suspicious incidents that threaten the life of the child or victim.
• Intoxications and apnea.
• Bleeding or hemorrhaging.
• Miscellaneous infections generated by various and sometimes unusual organisms.
• Medical history with little coherence and logicThe victims often spend a long time in the hospital with varied, contradictory and diffuse diagnoses, and the causes are almost never clear.
• The caregiver takes the victim very frequently to the doctor or to various doctors, until she feels sufficient satisfaction and attention.
• There are no witnesses in the family who have seen the various symptoms reported by the mother, as they only occur in her presence.
• The symptoms presented by the child often disappear in the hospital, however, they are reproduced again.However, they recur at the child's home, especially when in the care of one of the parents.
• Signs or symptoms occur comorbidly when the caregiver is present.
• Families with a history of sudden infant death or other serious problems in the child.
• The caregiver may have been seen performing somewhat suspicious acts that may imply a worsening in the victim.

As discussed above, the diagnosis of this syndrome is a challenge for the clinician.It is difficult to detect it when the mother tends to go to several hospitals, because for health professionals the observed facts will be isolated. Although pediatricians are trained to assess the credibility of certain stories, they do not tend to hypothesize that it is such an elaborate lie.

History of Munchausen's Syndrome by Proxy

PMS is a variant of Munchausen's SyndromeThe term was first introduced in 1977 by the English pediatrician Roy Meadow. This professional described at that time patients who had this syndrome as people who had spectacular, bizarre, made-up and lying medical histories, with the aim of getting medical attention.

Interestingly, in that same year two authors, Burman and Stevens, described a case in which a mother suffering from Munchausen's Syndrome (nowadays Factitious Disorder) was displacing it in her two young children. They called this phenomenon "Polle Syndrome", synonymous at the time with Munchausen's Syndrome (nowadays Factitious Disorder).synonymous in its day of the Syndrome of Munchausen by Proxy.

Causes and motivations

The causes of Munchausen syndrome by proxy are still unknown.. The studies on the subject that have interviewed perpetrators suggest that these suffered abuse in childhood, or suffer a Factitious Disorder.

The causes are not known, but progress has been made progress has been made in the study of the motivations of the parents involved.. In the first place, the person suffering from this syndrome does not act with the purpose of obtaining material or economic benefits. Paradoxically, they may invest large amounts of their money, effort and sacrifice in the "care" of their victim, despite the fact that they are inflicting great harm.

In short, their motivations are based on an excessive need for attention, care, pity, compassion, pity and/or recognition from medical and other by medical personnel and others for their great dedication to the victim. In addition, there appears to be a pathological ambivalent relationship towards the victim (caring vs. possible hidden rejection).

Treatment

What should be done in these situations? How should professionals who detect such a case proceed? Can the parent with this syndrome continue to care for his or her child?

There is no single appropriate course of action, and even less so when there may be a judicialization of the problem. Ultimately, the one who may receive more collateral damage is the child. (other children in the family, if any, should also be evaluated).

In these cases, the best interests of the child will always be paramount.. Clinicians should make sure that the diagnosis is certain and in the most severe cases, the child should be placed in safety (e.g. by separating the child from the family) and contact should be made with social services. It is very important to collaborate with other professionals and to carry out a multidisciplinary intervention.

Confession by the perpetrator is rare.. Therefore, treatment is often complex due to the parent's difficulties in recognizing his or her problems and trying to give them a coherent explanation. Necessarily, the parent suffering from Munchausen's Syndrome by Proxy must engage in psychotherapy, family therapy and/or the use of psychopharmaceuticals.