Hieronymous Karl Fredrich von Münchhausen was an 18th century German baron and mercenary officer in the Russian cavalry. On his return from the Russo-Turkish wars, the baron entertained friends and neighbors with stories of his many exploits. Over time, his stories grew more and more expansive.
In 1951, Dr. Richard Asher described a pattern of self-abuse, where individuals fabricated histories of illness. These fabrications invariably led to complex medical investigations, hospitalizations, and at times, needless surgery. Remembering Baron von Münchhausen and his untrustworthy tales, Asher named this condition Münchhausen's Syndrome.
The main feature of Münchhausen's syndrome is chronic, unrelenting, factitious, physical symptoms that enable the patient to obtain repeated medical treatment or hospitalization.
A variant of this disorder, involving a child and their caregiver, has been named Münchhausen Syndrome by Proxy (MSBP).
While Münchhausen Syndrome is recognized as a psychiatric disorder, Münchhausen Syndrome by Proxy (MSBP) is classified only as a form of child abuse.
MSBP occurs when a child's caregiver falsifies illnesses or produces symptoms in the child to obtain medical treatment. The result is more attention for the caregiver.
Doctors who are confronted with a case of Münchhausen Syndrome by Proxy deal with a baffling and relentless illness that is difficult to diagnose and seems resistant to all forms of treatment.
The symptoms can appear to be caused by a new or rare disorder with which the doctor has little experience. Medical testing usually return results within normal clinical parameters, indicating a healthy individual. This conflicts with the physical appearance of an ill child. Throughout the medical testing the mother appears very devoted to the child, which can keep medical staff from suspecting her as the cause of the health problems.
The child who is victimized by MSBP can be brought in repeatedly for medical examinations in an attempt to isolate the problem. The person inflicting injury on the child will intentionally change the hospital or doctor that they visit in order to prevent detection. Münchhausen Syndrome by Proxy cannot be diagnosed in only one visit. It requires a careful study of the child's medical history and recognition of a pattern of abuse in order for medical authorities to intervene in an MSBP case.
The following are some statistics about MSBP:
- 50% of the children have multiple symptoms
- 15% - 20% involve non-accidental poisoning
- 5% - 10% of the children die
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