Munchausen syndrome by proxy: ongoing clinical challenges

Journal of Pediatric Gastroenterology and Nutrition
Janet E Squires, Robert H Squires

Abstract

In 1977, Roy Meadow, a pediatric nephrologist, first described a condition he subsequently coined Munchausen syndrome by proxy. The classic form involves a parent or other caregiver who inflicts injury or induces illness in a child, deceive the treating physician with fictitious or exaggerated information, and perpetrate the trick for months or years. A related form of pathology is more insidious and more common but also damaging. It involves parents who fabricate or exaggerate symptoms of illness in children, causing overly aggressive medical evaluations and interventions. The common thread is that the treating physician plays a role in inflicting the abuse upon the child. Failure to recognize the problem is common because the condition is often not included in the differential diagnosis of challenging or confusing clinical problems. We believe that a heightened "self-awareness" of the physician's role in Munchausen syndrome by proxy will prevent or reduce the morbidity and mortality associated with this diagnosis. In addition, we believe contemporary developments within the modern health care system likely facilitate this condition.

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Citations

May 16, 2013·American Journal of Hematology·Stephanie K Bezner, George R Buchanan
Nov 19, 2011·The Laryngoscope·Matteo Alicandri-CiufelliLivio Presutti
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Feb 5, 2011·Current Opinion in Pediatrics·Jennifer DentonAndrea M Vandeven
Jul 9, 2011·Pediatric Hematology and Oncology·Özlem TüfekçiGülersu Irken

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