Munchausen syndrome by proxy (MSbP) or Factitious disorder imposed on another (FDIA)

Munchausen syndrome by proxy (MSbP) or Factitious disorder imposed on another (FDIA)

Munchausen syndrome by proxy (MSbP)

Munchausen syndrome is a term for a psychological pathology characterized by a need to simulate illness or trauma in order to gain attention or compassion.

This a condition in which a caregiver creates the appearance of health problems in another person, typically their child. This may include injuring the child or altering test samples. They then present the person as being sick or injured. The behaviour occurs without a specific benefit to the caregiver. Permanent injury or death may occur as a result of the disorder.


According to Donna Rosenberg (1987), four characteristics must apply:

1. Diseases of a child are incorrectly indicated, faked or artificially generated or maintained by a close caregiver, for example the mother.
2. The child is, often repeated, presented for medical examinations and treatments.
3. The true causes of the stated symptom or shown by the child are not stated in medical ideas.
4. Any acute symptoms or complaints in the child recede when separation from the causing person occurs.

The fake diseases often do not include symptoms or are difficult to detect by the doctor or Diseases such as B.epileptic seizures, schizophrenia, bulimia. An almost unlimited number of fake diseases are conceivable.

It was also described that perpetrators deliberately poison their victims, e.g. B. with medication to cause certain symptoms. According to the prevailing opinion, many of the mostly female perpetrators have relatively good medical expertise, are often members of a medical profession and can also mention the associated signs of the invented disease on questioning, so that the character of the “disease” is not noticeable and only the accumulation of visits to the doctor and the persistence with which treatment is requested, or the observation of the mother’s reaction to the communication of good or bad findings ultimately leads to mistrust.

According to the previous descriptions, the victims are often put under pressure, so that they often confirm observations of the perpetrator during visits to the doctor. Occasionally, the perpetrators threaten the victim with suicide. If the victim breaks out of the close relationship with the perpetrator burdened by such threats, he often falls into depression.

The causes of Münchhausen syndrome

The exact causes of Münchhausen syndrome are not known. Some psychoanalytic authors attribute this disorder to a defense mechanism against sexual and aggressive impulses. Others assume that Münchhausen’s syndrome is a way of punishing oneself for reasons most often unconscious. The presence of family conflicts and personality disorders can be involved in this pathology. In addition, professional experience in a medical environment can be a risk factor.


The person with Münchhausen syndrome sets his sights on a specific disease. Once she has studied it, she will find the means to induce the corresponding symptoms. To do this, she will not hesitate to poison herself, using chemical aids, or even inflict trauma on herself which will direct the doctor to the pathology that the person will have previously chosen.

Osmosis, CC BY-SA 4.0, via Wikimedia Commons

The more complex this condition will be and will require specific care, the more satisfaction the person will feel. If the doctor shows hesitation, the person with Münchhausen syndrome will guide them to the chosen disease. And if the doctor is reluctant or suspicious… She will change practitioner. You should know that it is also thanks to this procedure that these sick people can be spotted.

The combined effects of more wacky illnesses, a high number of scars due to surgical operations, or a lack of effects from prescribed drugs, eventually lead the doctor to the diagnosis of Münchhausen syndrome. .

Often, hospitalization is necessary. It is important to monitor these patients so that they do not have access to medication.

Munchausen syndrome by proxy (MSbP)

Described by the English pediatrician Roy Meadow in 1977, this syndrome is a particular form of child abuse. He described in the Lancet two cases of young children victims of pathologies invented or provoked by their mother: an iterative falsification of urine examinations by adding blood and chronic salt poisoning which led to the death of the child.

In general, the victims are often vulnerable people, dependent on this adult. This is the case for children, but also for the elderly or disabled. Usually it is a parent and their child. The responsible parent, the mother in 85% of cases, makes up false clinical stories in her child and / or provokes symptoms in order to ask doctors for a diagnosis and treatment. The serious and sometimes irremediable physical consequences come from the action of the parent and the abused medical profession.


It is also a question of separating them from the third person in the case of its form under proxy.

The treatment of Münchhausen syndrome by proxy is complex. It should be based on a detailed assessment of family functioning, the underlying psychological ground of the child and his parent, etc. This assessment can be done by a pediatrician, psychologist or child psychiatrist. In any case, the treatment should be instituted in a team, with the help of educators, etc.

Sometimes the abuse suffered by the child in the context of vicarious Münchhausen syndrome is such that hospitalization is necessary. Depending on the consequences on the health of the child, the treatment will have to take care of the induced symptoms such as pain for example. Parent-child follow-up should be offered when possible.

If the return home is not possible, the danger of recidivism is too great, a report must be made in order to separate the child from his abusive parent.

Diseases | List of Diseases: dermatological, cardiovascular, respiratory, cancer, eye, genetic, infectious, mental illness, rare

Information: Cleverly Smart is not a substitute for a doctor. Always consult a doctor to treat your health condition.

Sources: PinterPandai, Michigan Medicine, Web MD, Cleveland Clinic

Photo credit: Osmosis / Wikimedia Commons (CC BY-SA 4.0)

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