Munchausen Syndrome and Munchausen Syndrome by Proxy

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Common Characteristics MSBP Victims Dependent Display separation anxiety Immature Symbiotic relationship with caregiver Views offender as ideal parent Passively tolerates medical procedures Excessive school absence Not involved in normal social activities Failure to thrive Illness corresponds with presence of caregiver Illness resolves with close surveillance From: Holstege and Dobmeier. “Criminal Poisoning: Munchausen by Proxy”. Clin Lab Med 26 (2006) 24
Suspicions for MSBP Child with multiple hospitalizations/medical visits Medical problems unresponsive to treatment, follow unusual course PE/lab findings that are highly unusual, don’t fit with history, or are impossible Caregiver is medically knowledgeable or is interested in medical details Caregiver enjoys being in hospital environment
Page 1 and 2: Munchausen Syndrome and Munchausen
Page 3 and 4: Fatal child abuse Typically from P
Page 5 and 6: Malingering vs. Muchausen Malinger
Page 7 and 8: Munchausen Syndrome Need to assume
Page 9 and 10: Recent changes to nomenclature APS
Page 11 and 12: MSBP Typically seen in children Fo
Page 13 and 14: Epidemiology True numbers unknown
Page 15 and 16: Simulating illness State false his
Page 17 and 18: Victims Usually less than 5 years
Page 19: Common Characteristics MSBP Offende
Page 23 and 24: Suspicions for MSBP Symptoms not p
Page 25 and 26: Poisonings Very difficult to diffe
Page 27 and 28: Vomiting and ipecac Most common re
Page 29 and 30: Difficulties in recognition Majori
Page 31 and 32: Covert Video Surveillance Allows f
Page 33 and 34: Role of Physician Usually the firs
Page 35 and 36: Role of Risk Management Evaluate t
Page 37 and 38: Role of Attorney Work with risk ma
Page 39 and 40: Team approach “The complexities i
Page 41 and 42: CHOA cases 23 of the 41 cases were
Page 43 and 44: Mothers’ behaviors Remarkable fo
Page 45 and 46: Atlanta presenting signs/symptoms
Page 47 and 48: MSBP ruled out by CVS 4 cases with
Page 49 and 50: As in the AJC 3/12/07 Father caught
Page 51 and 52: Per the website www.msbp.com “The
Page 53 and 54: AAP Recognize MSBP States that CV
Page 55 and 56: A diagnosis is made, now what? Fir
Page 57 and 58: Survivors of MSBP Many suffer from
Page 59 and 60: Confusion and misdiagnosis Patient
Page 61 and 62: Role of community Recognize that M
Page 63 and 64: Case of MSBP in PICU Not previousl
Page 65 and 66: Summary of MSBP Caregiver, typical
Page 67: Questions

Munchausen Syndrome and Munchausen Syndrome by Proxy

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