Abstract
Munchausen syndrome and Munchausen by proxy syndrome belong belong to a group of disease called “factitious disorder” and are severe mental disorders having the “end” position for a healthy person to become patient, respectively to “create” a disease to another person, asking or requiring medical intervention for him/her. Munchausen syndrome by proxy is rare, but it is difficult to be recognized and confirmed, is a form of abuse, particularly against children, potentially lethal, often misunderstood. Many methods are used by adults counterfeiters to induce a false child’s condition: poisoning, injury, producing bleeding, infection. Complaints exposed by the mothers as belonging to the child are not for a personal benefit, but are justified by a desire to be a “hero” mothers and to play the role of the people most attached and thoughtful of their child. Diagnosis should include evaluation of the child, parents and family and is based on suggestive elements: child with multiple health problems that do not respond to treatment or recur under proper therapy, laboratory investigations discrepancies, child’s signs and symptoms disappear in the absence of the parent. The false disease of the child, intentionally distorted described by adult, do not really affect him/her, but the diagnostic process and medical treatment can cause pain and discomfort. Ethical and legal issues associated with MSBP involves healthcare professionals by the medical consequences on the child as a result of false complains described by the parent. Education of patient, family and medical personnel is a very important step in the recognition, prevention and treatment of MSBP.
Highlights
Munchausen syndrome and Munchausen by proxy syndrome belong belong to a group of disease called “factitious disorder” and are severe mental disorders having the “end” position for a healthy person to become patient, respectevely to “create” a disease to another person, asking or requiring medical intervention for him/her
Richard Asher in 1951 described a bizarre entity characterized by deliberate falsification of the disease’s history, in order to take advantage og medical examinations invasive or non-invasive. This condition paid the attention of many doctors and psychologists, initially called “Munchausen syndrome”. [1] In 1977 Meadow published two cases, called “Munchausen Syndrome by Proxy” in which the child’s symptoms were caused and/or invented by his mother!! Since Munchausen syndrome by Proxy was recognized as a form of child abuse. [2]
Munchausen syndrome and Munchausen syndrome by proxy, having the “end” position for a healthy person to become patient, belong to a group of disease called “factitious disorder” (“disorders unnatural, artificial, fake”) and represent severe mental disorders classified in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). [3,4,5]
Summary
Munchausen syndrome is a mental disorder (most likely belonging to the psychiatric pathology) associated with severe emotional difficulties, expressed by hospital patient dependency with the aim to get attention and assistance of the medical team and to become patient, without any material or financial benefits. Patients noncompliant are patients who are actively or passively fail to manage a child’s treatment for a diagnosis, sometimes with an severe outcome These parents either deny the reality, or not understand the situation, or are deprived of responsibility and let children to develop the worsening disease despite efforts by medical personnel. 217/2003 on domestic violence, that states that “Munchausen Syndrome by transfer (MBP) is the artificial creation of a child fake diseases by the parent; disease is induced by administration of drugs for poisoning, or by supporting the existence of symptoms in children who have never been confirmed by the specialists In both cases, many parents require medical or surgical investigation, abusing the child repeatedly. Mothers of MSBP victims can be so compelling that, friends, family members and even medical team defends them and believe they are wrongly accused when unmasking
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