Munchausen Syndrome Research Articles

Munchausen syndrome: A differential diagnostic trap for hand surgeons

A 24-year-old woman was referred with an extremely painful, stiff, swollen, and hypersensitive right upper extremity. She had history of four previous operations on the same extremity. The primary diagnosis was complex regional pain syndrome. During the next few days her symptoms worsened and she developed fever. It was discovered that the patient was preheating more than one thermometer and was intentionally injuring herself. The final diagnosis was Munchausen syndrome.

Dermatite factícia desencadeada pela síndrome de Münchausen

Factitial dermatitis is a condition in which skin lesions are self-inflicted as the result of a psychiatric disorder. The lesions may be presented in various forms and produced by a wide variety of means. This report refers to the case of a patient with factitial dermatitis triggered by Munchausen syndrome, which refers to individuals who intentionally provoke physical symptoms in themselves in order to satisfy a need to receive frequent medical attention.

Every patient tells a story

Every patient tells a story

P01-296 - “I don’t want to be a patient”: case report on Munchausen's Syndrome

ObjectivesThe Munchausen's Syndrome, first described by the English doctor Richard Asher in 1951, refers to a factitious disorder present in patients who are repeatedly admitted in medical emergencies for apparent serious diseases and are looking forward to intensive medical care. The authors present a challenging case report, highlighting the importance of a thorough medical investigation before setting into Munchausen's Syndrome stigmatizing diagnosis.MethodsThe authors present a case studied in an Oncological Center, with emphasis on the medical data, diagnostic process, multidisciplinary approach, family-social-occupational implications and outcome. A review on Munchausen's Syndrome, using Medline database, focusing on the last decade publications on the subject, was carried out.ResultsThe clinical presentation initially led to strong suspicion towards Munchausen's Syndrome, since it was an young adult, single, health related profession (doctor), with life event triggers (family and social isolation; affective rupture).With the on going diagnostic process, it ended out on an atypical presentation of Crohn's Disease. However, the stigmatizing label had already been set, adding psychological damage to the patient (adjustment depressive disorder).ConclusionFrom the Munchausen's Syndrome review in recent literature, the authors conclude that this rare diagnosis is even rarer on oncologic settings. It should always be an exclusion diagnosis, made after a careful medical screening carried on by an expert and multi-disciplinary team, which should include a liaison psychiatrist. The patient presented classical Munchausen's clinical profile, which can be misleading by it self, incurring into a misdiagnosis.

Munchausen syndrome: a case report

Munchausen syndrome: a case report

A Case Of Munchausen Syndrome Admitting With Hemorrhage

Munchausen syndrome cases are characterized by making up false symptoms to mislead the physicians. Early diagnosis of the sickness is essential due to the difficulty of its diagnosis and treatment. This study presents a case who checked in the emergency service with the complaint of continuous bleeding and who was considered to experience Munchausen syndrome

“Through a glass, darkly”: the clinical and ethical implications of Munchausen syndrome

“Through a glass, darkly”: the clinical and ethical implications of Munchausen syndrome

Munchausen syndrome by proxy mimicking as Gaucher disease

Although rare, Munchausen syndrome by proxy (MBP) is a potentially life-threatening form of child abuse. Here, we report a 19-month-old female infant who presented with hepatosplenomegaly, anemia, thrombocytopenia, and recurrent septicemia. She was initially thought to have myelodysplastic syndrome. Further hematological and immunological investigations revealed no cause. beta-Glucosylceramidase enzyme activity on dried blood spot was suggestive of Gaucher disease. However, the enzyme level on cultured skin fibroblast was not consistent with Gaucher disease. The first hint about MBP was the recurrent sepsis with numerous gram negative rods. Furthermore, the mother's behavior and health history raised our suspicion about MBP. The child showed significant improvement after she was separated from the mother for a week. Finally, the mother confessed that she was spitting in local herbs and injecting it into the central line. This is, to our knowledge, the first report of MBP resembling in its presentation Gaucher disease. This case should alert the general and specialized pediatricians about MBP, as it may mimic metabolic diseases like Gaucher disease.

Factitious disorder (Munchausen’s syndrome)

Factitious disorder, often referred to as Munchausen's syndrome, is a condition in which sufferers present to healthcare professionals seeking investigation and treatment for signs and symptoms that they have consciously fabricated for no obvious reason. Factitious presentations have been described all over the world, in every medical specialty and in every age group, yet by its very nature factitious disorder is difficult to study. There is therefore a dearth of evidence in the literature relating to epidemiology, aetiology and therapeutics. The disorder is notoriously difficult to recognise in clinical practice and there are as yet no definitive treatment options available. This article provides a brief overview of the literature before offering guidance on the diagnosis and management of factitious disorder presenting in the general hospital. It also considers fabricated or induced illness, also known as Munchausen's syndrome by proxy.

Voices for Psychologically Injured Children: Psychoanalytic Testimony During Civil Litigation Helps Bring Social Change, Settlements, and Jury Awards

Because of its depth and scope, child psychoanalytic testimony can make major contributions to the civil justice system. Attorneys can strategically use such testimony to favorably influence institutional practices and standards of children's care. When requested by a skilled attorney, carefully integrated with that attorney's professional tasks and skills, psychoanalytic testimony can lead to more thorough and knowledgeable compensation for injured children than occurs with superficial approaches to the course of psychological pathology and care. Governments and institutions are then likely to be required by courts and juries to pay appropriate, rather than token, compensation for negligently allowing children to be traumatized in life-damaging ways. The author draws on his experience in the field of psychoanalysis and forensic child psychiatry, in over 200 separate cases, most of them civil, many with multiple victims. About 70% were requested by child plaintiffs' attorneys, and 30% by defense attorneys. Despite important failures, such as in defense of a mother accused of the scientifically questionable condition called Munchausen syndrome by proxy, the cumulative impact of the psychoanalytic forensic endeavor helps increase beneficial social change. Child protection standards improve, and major compensation is given traumatized children when the negligent or abusive parties are held financially responsible. To show the measurable significance that the judicial system gives to psychoanalytically informed evaluations and testimony, the author draws upon plaintiff children's cases through 2001. Among these cases, his reports and testimony helped attorneys bring about awards and settlements totaling over a quarter billion dollars, when the non-profit project described ended.

Munchausen Syndrome by Proxy

1. Patrick Brown, MD 2. Cheryl Tierney, MD, MPH 1. Baystate Medical Center Springfield, Mass Diagnostic and Statistical Manual of Mental Disorders. DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000:781– 783 Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in a Medical Setting. Stirling J and the Committee on Child Abuse and Neglect. Pediatrics. 2007;119 :1026– 1030[OpenUrl][1][Abstract/FREE Full Text][2] Munchausen Syndrome by Proxy. Hettler J. Pediatr Emerg Care. 2002;18 :371– 374[OpenUrl][3][CrossRef][4][PubMed][5][Web of Science][6] Different Interpretations of Munchausen Syndrome by Proxy. Meadow R. Child Abuse Neglect. 2002;26 :501– 508[OpenUrl][7][CrossRef][8][PubMed][9][Web of Science][10] The term Munchausen syndrome has long been recognized in adult patients who fabricate symptoms for the purpose of adopting the sick role and submitting themselves to unnecessary medical procedures. In pediatrics, this condition takes a different spin when a parent presents with a story of symptoms in his or her child, who then becomes the focus of medical investigation. Because the patient is not directing the signs and symptoms of the condition, the name of this condition is Munchausen syndrome by proxy (MSBP). MSBP was introduced in the medical literature in 1977 by … [1]: {openurl}?query=rft.jtitle%253DPediatrics%26rft.stitle%253DPediatrics%26rft.issn%253D0031-4005%26rft.aulast%253DStirling%26rft.auinit1%253DJ.%26rft.volume%253D119%26rft.issue%253D5%26rft.spage%253D1026%26rft.epage%253D1030%26rft.atitle%253DBeyond%2BMunchausen%2BSyndrome%2Bby%2BProxy%253A%2BIdentification%2Band%2BTreatment%2Bof%2BChild%2BAbuse%2Bin%2Ba%2BMedical%2BSetting%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.2007-0563%26rft_id%253Dinfo%253Apmid%252F17473106%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=119/5/1026&atom=%2Fpedsinreview%2F30%2F10%2F414.atom [3]: {openurl}?query=rft.jtitle%253DPediatric%2Bemergency%2Bcare%26rft.stitle%253DPediatr%2BEmerg%2BCare%26rft.aulast%253DHettler%26rft.auinit1%253DJ.%26rft.volume%253D18%26rft.issue%253D5%26rft.spage%253D371%26rft.epage%253D374%26rft.atitle%253DMunchausen%2Bsyndrome%2Bby%2Bproxy.%26rft_id%253Dinfo%253Adoi%252F10.1097%252F00006565-200210000-00012%26rft_id%253Dinfo%253Apmid%252F12395011%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=10.1097/00006565-200210000-00012&link_type=DOI [5]: /lookup/external-ref?access_num=12395011&link_type=MED&atom=%2Fpedsinreview%2F30%2F10%2F414.atom [6]: /lookup/external-ref?access_num=000178625100011&link_type=ISI [7]: {openurl}?query=rft.jtitle%253DChild%2Babuse%2B%2526%2Bneglect%26rft.stitle%253DChild%2BAbuse%2BNegl%26rft.aulast%253DMeadow%26rft.auinit1%253DR.%26rft.volume%253D26%26rft.issue%253D5%26rft.spage%253D501%26rft.epage%253D508%26rft.atitle%253DDifferent%2Binterpretations%2Bof%2BMunchausen%2BSyndrome%2Bby%2BProxy.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0145-2134%252802%252900326-5%26rft_id%253Dinfo%253Apmid%252F12079086%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: /lookup/external-ref?access_num=10.1016/S0145-2134(02)00326-5&link_type=DOI [9]: /lookup/external-ref?access_num=12079086&link_type=MED&atom=%2Fpedsinreview%2F30%2F10%2F414.atom [10]: /lookup/external-ref?access_num=000175949600006&link_type=ISI

Munchausen Syndrome by Proxy

Munchausen Syndrome by Proxy

Medical Child Abuse: Beyond Munchausen Syndrome by Proxy

Medical Child Abuse: Beyond Munchausen Syndrome by Proxy

Munchausen Syndrome by Proxy: Implications for Professional Practice in Relation to Children's Education

This article discusses the wider implications of a pattern of behaviour in which a parent, usually the mother, persistently presents a false story of illness or disability in the child. Such behaviour can be harmful to the child. The parent may deliberately produce symptoms of illness; the child may be exposed to unnecessary but painful and damaging medical investigations and treatments; the child's participation in education and social life may be unnecessarily limited; and the child may develop a view of themselves as disabled. Should this pattern of behaviour be seen solely in a medical context, or can the behaviour occur in educational contexts, too? The literature includes a small number of cases where members of school staff, psychologists and education administrators have faced persistent but fabricated claims of illness, disability or learning difficulty needing special educational provision. Identifying such fabrication presents professionals with emotional as well as practical challenges. The notion that a mother might deliberately fabricate or provoke symptoms of illness or disability in her child is in itself an assertion that is hard to accept. Strongly-held, polarised views can be generated between those professionals who defend particular mothers and those who suspect them. There may be aspects of special educational needs law and practice that add to the difficulties faced by practitioners needing to distinguish between benign parental advocacy and malign fabrication. Some tentative suggestions are offered about how practitioners can be alert to possible cases of fabrication; and about how our knowledge about educational manifestations of fabrication might be refined.

Non-accidental chlorpyrifos poisoning—an unusual cause of profound unconsciousness

Chlorpyrifos is an organophosphorus anticholinesterase insecticide, and organophosphate intoxication can induce symptoms such as miosis, urination, diarrhea, diaphoresis, lacrimation, excitation of central nervous system, salivation, and consciousness disturbance (MUDDLES). Although accidental poisoning of children with drugs and chemicals is a common cause for consciousness disturbance in children, the possibility of deliberate poisoning is rarely considered. We report on a healthy 5-year 6-month-old boy with recurrent organophosphate intoxication. Reports of chlorpyrifos intoxication in children are quite rare. This case report demonstrates decision-making process and how to disclose deliberate chlorpyrifos poisoning of the toddler by the stepmother, another example of Munchausen syndrome by proxy.

Munchausen's syndrome in the allogeneic stem cell transplantation setting: a rare but potentially devastating condition

Munchausen's syndrome in the allogeneic stem cell transplantation setting: a rare but potentially devastating condition

“Through a glass, darkly”: the clinical and ethical implications of Munchausen syndrome

Patients who present repeatedly for care with medically unexplained symptoms raise challenges for the health system. One proposed strategy for dealing with such patients is the introduction of electronic medical records (EMRs) to identify these patients and thus limit the demands on resources their management involves. This measure may ultimately be appropriate but fails to consider equally critical core issues in psychiatric ethics. Identifying patients as "somatisers" invites a problematic relaxation of clinical vigilance, increasing the likelihood that an actual life-threatening medical problem will not be identified. Management of such patients requires regular, structured therapeutic contact with a skilled mental health clinician, that is independent of the patient's distress level. Psychiatric problems and medical problems are frequently seen as two distinct, unrelated categories. This is a false dichotomy, as mental health and physical health are interdependent. Given patient privacy considerations, EMRs would be unlikely to reveal the kind of sensitive mental health information needed for the identification and management of somatising patients in busy health systems. Cost-effective interventions for somatising patients' problematic behaviour, such as structured clinical intervention, antidepressant medication and cognitive behaviour therapy, are available at a fraction of the cost of EMR systems. Citing cost savings as a justification for violating the privacy of mental health patients compounds the manifest injustice these patients already face in the health system.

Medical child abuse: beyond Munchausen syndrome by proxy

Acta PaediatricaVolume 98, Issue 9 p. 1542-1542 Medical child abuse: beyond Munchausen syndrome by proxy Göran Bodegård, Göran Bodegård goran.bodegard@comhem.seSearch for more papers by this author Göran Bodegård, Göran Bodegård goran.bodegard@comhem.seSearch for more papers by this author First published: 27 July 2009 https://doi.org/10.1111/j.1651-2227.2009.01363.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume98, Issue9September 2009Pages 1542-1542 RelatedInformation

A case of Munchausen syndrome by proxy

As a retired German cavalry officer, Karl Friedrich Hieronymous Freiherr von (Baron) Munchausen (172097) acquired a reputation as a raconteur of preposterous stories about his adventures as a soldier, hunter, and sportsman 1 . Asher in 1951 first reported patients who consistently produced false stories and fabricated medical evidence which led to needless medical investigations, operations and treatments 2 . Roy Meadow in 1977 described a condition, Munchausen syndrome by proxy, where the mother, a relative or a caregiver fabricated illnesses in children 3 . Since then, many reports of this condition have been published in the medical literature from allover the world.

Sentencing Offenders with Munchausen Syndrome by Proxy

In the decision of Burnton J of the English High Court in Re Allitt [2007] EWHC 2845 the issue of the criminal responsibility of a woman diagnosed with Munchausen Syndrome by Proxy was scrutinised. The determination of whether the offender should receive a minimum sentence focused upon her personality dysfunction, rather than upon diagnosis of a syndrome that continues to be in a degree of flux. The decision is likely to encourage the adoption of an approach that concentrates less than previously upon assessment of whether the tentative diagnostic criteria for Munchausen Syndrome by Proxy or Factitious Disorder by Proxy are satisfied.