Munchausen Syndrome by Proxy

Exams and Tests

Munchausen syndrome by proxy (MSBP) is diagnosed if the following criteria are met:²

• Evidence proves that the caregiver is intentionally causing or reporting symptoms in another person under his or her care (a proxy).
• The caregiver seems to be motivated by involvement with the illness of the person under his or her care.
• No outside incentives or motivations (such as payment for false medical claims) account for the caregiver causing or reporting illness in the other person.
• The caregiver is not suffering from any other mental illness.

Doctors who suspect MSBP in a caregiver usually avoid putting the child through unnecessary tests. The child may be admitted to a hospital where he or she is carefully examined and observed. Health professionals also observe first-hand or video-record the caregiver's behavior as they try to discover whether she is producing the symptoms in her child.

A review of past medical records may provide useful information or show inconsistencies about past examinations, tests, treatments, and even hospital stays that can help determine whether a child's illness is real. But if the offending caregiver has provided false information, medical records can be misleading. Medical records may show that the caregiver has frequently consulted new doctors—the caregiver may change doctors to avoid confrontation with evidence of induced or fabricated illness in the child. In rare cases, a doctor gives in to the parent's demands for a diagnosis and treatment to calm a demanding or threatening parent.

If MSBP is confirmed or highly suspected, health professionals are required by law to file a report with the local health department or child welfare agency.

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Author:	Jeannette Curtis	Last Updated: July 27, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine Michael J. Sexton, MD - Pediatrics
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