munchausen syndrome by proxy


Summary: A phenomenon in which symptoms of a disease are fabricated by an individual other than the patient causing unnecessary, and often painful, physical examinations and treatments. This syndrome is considered a form of CHILD ABUSE, since another individual, usually a parent, is the source of the fabrication of symptoms and presents the child for medical care.

Top Publications

  1. Ayoub C, Schreier H, Keller C. Munchausen by proxy: presentations in special education. Child Maltreat. 2002;7:149-59 pubmed
    ..Guidelines for identification of children with PCF in educational settings are provided, and special guidance is offered in differential diagnosis. ..
  2. Galvin H, Newton A, Vandeven A. Update on Munchausen syndrome by proxy. Curr Opin Pediatr. 2005;17:252-7 pubmed
    b>Munchausen syndrome by proxy (MBP) is a complicated form of child maltreatment. Difficulties remain in properly defining the condition, as well as in detection and differentiation from organic illness...
  3. Hall D, Eubanks L, Meyyazhagan L, Kenney R, Johnson S. Evaluation of covert video surveillance in the diagnosis of munchausen syndrome by proxy: lessons from 41 cases. Pediatrics. 2000;105:1305-12 pubmed
    ..GA) added facilities to perform inpatient covert video surveillance (CVS) of suspected cases of Munchausen syndrome by proxy (MSBP). Forty-one patients were monitored from 1993 to 1997...
  4. Schreier H. Munchausen by proxy defined. Pediatrics. 2002;110:985-8 pubmed
  5. Tamay Z, Akcay A, Kilic G, Peykerli G, Devecioglu E, Ones U, et al. Corrosive poisoning mimicking cicatricial pemphigoid: Munchausen by proxy. Child Care Health Dev. 2007;33:496-9 pubmed
    ..Physicians must consider the diagnosis of MBP whenever they are confronted with unusual, persistent or recurrent signs and symptoms in a child. ..
  6. Milroy C. Munchausen syndrome by proxy and intra-alveolar haemosiderin. Int J Legal Med. 1999;112:309-12 pubmed
    b>Munchausen syndrome by proxy is characterised by the invention of a false history and/or the deliberate inducement of a factitious illness by parents in their child...
  7. Al Owain M, Al Zaidan H, Al Hashem A, Kattan H, Al Dowaish A. Munchausen syndrome by proxy mimicking as Gaucher disease. Eur J Pediatr. 2010;169:1029-32 pubmed publisher
    Although rare, Munchausen syndrome by proxy (MBP) is a potentially life-threatening form of child abuse...
  8. Munro H, Thrusfield M. 'Battered pets': Munchausen syndrome by proxy (factitious illness by proxy). J Small Anim Pract. 2001;42:385-9 pubmed
    Nine cases of suspected Munchausen syndrome by proxy (MSBP), involving pets as proxies, were identified among 448 cases of non-accidental injury to small animals...
  9. Al Haidar F. Munchausen syndrome by proxy and child's rights. Saudi Med J. 2008;29:452-4 pubmed
    b>Munchausen syndrome by proxy (MSBP) is an extreme form of child abuse in which perpetrators induce life-threatening conditions in their children. A case of MSBP is described in detail...

More Information


  1. Giurgea I, Ulinski T, Touati G, Sempoux C, Mochel F, Brunelle F, et al. Factitious hyperinsulinism leading to pancreatectomy: severe forms of Munchausen syndrome by proxy. Pediatrics. 2005;116:e145-8 pubmed
    ..One percent (2 of 250) of all cases of hyperinsulinemic hypoglycemia in our unit have been identified as Munchausen syndrome by proxy. Atypical disease history should raise the question of factitious hypoglycemia.
  2. Barros A, Rosa R, Telles L, Taborda J. Attempted Serial Neonaticides: Case Report and a Brief Review of the Literature. J Forensic Sci. 2016;61:280-3 pubmed publisher
  3. Sugar J, Belfer M, Israel E, Herzog D. A 3-year-old boy's chronic diarrhea and unexplained death. J Am Acad Child Adolesc Psychiatry. 1991;30:1015-21 pubmed
    ..The fatal case of a three year-old boy hospitalized for chronic diarrhea is described. The diagnosis of Munchausen's by Proxy is discussed, and the approach to such cases is explored. ..
  4. Kirschbaum K, Musshoff F, Madea B. Unclear loss of consciousness after clobutinol intake. Forensic Sci Int. 2009;189:e37-40 pubmed publisher
    ..did not lead to any explanation of his condition, the administration of drugs in the context of Munchausen syndrome by proxy was suspected...
  5. Janas Kozik M, Albert J, Kresimon E, Stokowacka Zakrzewska M, Wawrzyniak K. [Somatic disease or Munchausen syndrome by proxy? Mother's or child's disease? Diagnostic controversies]. Przegl Lek. 2007;64 Suppl 3:72-5 pubmed
    INTRODUCTIONn: The Munchausen Syndrome by Proxy occurs when parents make a child believe he or she suffers from a disease while in fact this is not true...
  6. Christie Smith D, Gartner C. Special report: highlights of the 2004 Institute on Psychiatric Services. Psychiatr Serv. 2005;56:16-21 pubmed
  7. Lasher L. Munchausen by Proxy (MBP) maltreatment: an international educational challenge. Child Abuse Negl. 2003;27:409-11 pubmed
  8. Vanelli M. Munchausen's syndrome by proxy web-mediated in a child with factitious hyperglycemia. J Pediatr. 2002;141:839 pubmed
  9. Sanders M, Bursch B. Forensic assessment of illness falsification, Munchausen by proxy, and factitious disorder, NOS. Child Maltreat. 2002;7:112-24 pubmed
    ..a) Is there evidence that child abuse did occur? (b) Does the alleged perpetrator meet criteria forfactitious disorder, NOS (or factitious disorder by proxy)? and (c) What management and treatment recommendations should be made? ..
  10. Kórász K. [Psychiatric aspects of child maltreatment]. Orv Hetil. 2014;155:694-702 pubmed publisher
    ..A brit és a magyar jogi vonatkozások, módszertani irányelvek, valamint a probléma feltárásában és kezelésében a pszichiáter szerepe és felel?ssége is megbeszélésre kerül. Orv. Hetil., 2014, 155(18), 694–702. ..
  11. Bursch B, Schreier H, Ayoub C, Libow J, Sanders M, Yorker B. Further thoughts on "Beyond Munchausen by proxy: identification and treatment of child abuse in a medical setting". Pediatrics. 2008;121:444-5; author reply 445 pubmed publisher
  12. Pankratz L. Persistent problems with the Munchausen syndrome by proxy label. J Am Acad Psychiatry Law. 2006;34:90-5 pubmed
    After nearly 30 years of clinical and legal experience, the definition of Munchausen syndrome by proxy remains controversial...
  13. Warner J. Child protection and allergy. Pediatr Allergy Immunol. 2005;16:621 pubmed
  14. Lindahl M. Beyond Munchausen by proxy: a proposed conceptualization for cases of recurring, unsubstantiated sexual abuse allegations. J Child Sex Abus. 2009;18:206-20 pubmed publisher
    ..Defining the set of cases more clearly can aid child protection workers in their management and encourage research on prevalence, consequences to children, treatment strategies, and needed legal reforms. ..
  15. Kannai R. Munchausen by mommy. Fam Syst Health. 2009;27:105-12 pubmed publisher
    ..Only careful inspection by the medical teams, dialogue and co-operation can bring to an end the harmful behavior of Joy's mother. ..
  16. Ben Yehuda Y. [Medical child abuse, another name for Munchausen's syndrome by proxy]. Harefuah. 2009;148:500-1, 574 pubmed
    ..In this article we describe medical child abuse and the means of diagnosing the syndrome. It is also stressed that, as in the case of any other form of child maltreatment, reporting is mandatory. ..
  17. Denny S, Grant C, Pinnock R. Epidemiology of Munchausen syndrome by proxy in New Zealand. J Paediatr Child Health. 2001;37:240-3 pubmed
    To determine the epidemiology of Munchausen syndrome by proxy (MSBP) in New Zealand and describe the effects of this condition on children and their paediatricians. A mail-out survey was sent to all paediatricians in New Zealand in 1999...
  18. Kucuker H, Demir T, Oral R. Pediatric condition falsification (Munchausen syndrome by Proxy) as a continuum of maternal factitious disorder (Munchausen syndrome). Pediatr Diabetes. 2010;11:572-8 pubmed publisher
    Pediatric condition falsification (PCF), also known as Munchausen syndrome by Proxy or Medical Child Abuse, is a somewhat rare form of child abuse and neglect...
  19. Saad G. Munchausen by proxy: the dark side of parental investment theory?. Med Hypotheses. 2010;75:479-81 pubmed publisher
    ..b>Munchausen Syndrome by Proxy (MSbP) occurs when a caregiver feigns or causes a medical condition in a dependent (typically a child)...
  20. Olry R, Haines D. Historical and literary roots of Münchhausen syndromes: as intriguing as the syndromes themselves. Prog Brain Res. 2013;206:123-41 pubmed publisher
    ..This chapter examines the legitimacy of these terms in the light of historical and literary records and analyzes the synonyms or clinical types as found in medical publications. ..
  21. Thomas K. Munchausen syndrome by proxy: identification and diagnosis. J Pediatr Nurs. 2003;18:174-80 pubmed
    ..b>Munchausen Syndrome by Proxy (MSBP) is a hidden and deceitful abuse whereby a caretaker of a child, usually the mother, fabricates ..
  22. Hettler J. Munchausen syndrome by proxy. Pediatr Emerg Care. 2002;18:371-4; quiz 375-6 pubmed
  23. Berent D, Florkowski A, Gałecki P. [Münchausen syndrome by proxy]. Psychiatr Pol. 2010;44:245-54 pubmed
  24. Bouaziz Abed A, Mustapha R, Chiha M. [Fortuitous discovery of intracerebral foreign body leads to the diagnosis of Munchausen syndrome by proxy]. Arch Pediatr. 2011;18:1181-4 pubmed publisher
    ..The fortuitous discovery at 22 months of age of a 4.5-cm-long sewing needle in his brain probably introduced via the fontanel led us to the diagnosis of Munchausen syndrome by proxy.
  25. Fujiwara T, Okuyama M, Kasahara M, Nakamura A. Differences of Munchausen syndrome by proxy according to predominant symptoms in Japan. Pediatr Int. 2008;50:537-40 pubmed publisher
    The purpose of the present paper was to investigate differing characteristics of Munchausen syndrome by proxy (MSBP) between subjects with predominantly physical symptoms and those with predominantly psychological symptoms...
  26. Greiner M, Palusci V, Keeshin B, Kearns S, Sinal S. A preliminary screening instrument for early detection of medical child abuse. Hosp Pediatr. 2013;3:39-44 pubmed
  27. Feldman K, Stout J, Inglis A. Asthma, allergy, and sinopulmonary disease in pediatric condition falsification. Child Maltreat. 2002;7:125-31 pubmed
    ..Children with PCF are not only subjected to induced illnesses and excessive medical diagnostic and therapeutic efforts but also victimized b) the consequences of false and exaggerated complaints of common pediatric diseases. ..
  28. Wenk R. Molecular evidence of Munchausen syndrome by proxy. Arch Pathol Lab Med. 2003;127:e36-7 pubmed
    Many perpetrators of Munchausen syndrome by proxy present bloodstained materials as counterfeit evidence of proxy hemorrhage...
  29. Le Heuzey M, Mouren M. [Münchhausen syndrome by proxy]. Arch Pediatr. 2008;15:85-8 pubmed publisher
    ..Physicians participate in the abuse by their therapeutic and diagnostical measures. It is very important to think about this diagnostic in any ambiguous situation in order to evaluate and protect the child. ..
  30. Freckelton I. Munchausen Syndrome bx proxy and criminal prosecutions for child abuse. J Law Med. 2005;12:261-6 pubmed
  31. Feldman M. Munchausen by proxy and malingering by proxy. Psychosomatics. 2004;45:365-6 pubmed
  32. Dyer C. Inquiry into death of boy from induced illness recommends tightening of child protection rules. BMJ. 2004;329:191 pubmed
  33. Leuthner S. Covert video surveillance in pediatric care: the fiduciary relationship with a child. J Clin Ethics. 2004;15:173-5 pubmed
  34. Meadow R. Different interpretations of Munchausen Syndrome by Proxy. Child Abuse Negl. 2002;26:501-8 pubmed
    The definition of Munchausen Syndrome by Proxy is reviewed and considered in the context of the overlap with other harmful behaviors of parents...
  35. Adshead G. Evidence-based medicine and medicine-based evidence: the expert witness in cases of factitious disorder by proxy. J Am Acad Psychiatry Law. 2005;33:99-105 pubmed
  36. Wrennall L. Munchausen Syndrome by Proxy/Fabricated and Induced Illness: does the diagnosis serve economic vested interests, rather than the interests of children?. Med Hypotheses. 2007;68:960-6 pubmed
    The discourse of Munchausen Syndrome by Proxy/Fabricated and Induced Illness posits the widespread incidence of a highly dangerous form of child abuse in which illness and developmental delay in children, is caused by their parents or ..
  37. Flaherty E, MacMillan H. Caregiver-fabricated illness in a child: a manifestation of child maltreatment. Pediatrics. 2013;132:590-7 pubmed publisher
    ..Although caregiver-fabricated illness in a child has been widely known as Munchausen syndrome by proxy, there is ongoing discussion about alternative names, including pediatric condition falsification, ..
  38. Griffiths H, Cuddihy P, Marnane C. Bleeding ears: a case of Munchausen syndrome by proxy. Int J Pediatr Otorhinolaryngol. 2001;57:245-7 pubmed
    ..a period of time it became apparent that the persistent aural bleeding, which is an uncommon feature of Chronic Suppurative Otitis Media, was the result of trauma inflicted by its mother; a case of Munchausen syndrome by proxy (MSBP).
  39. Turkmen Z, Ziyalar N, Tari I, Mercan S, Kayiran S, Sener D, et al. Toxicological evaluation of two children diagnosed as Munchausen syndrome by proxy. Turk J Pediatr. 2012;54:283-6 pubmed
    b>Munchausen syndrome by proxy is a kind of child abuse in which affected children are often hospitalized for long periods and endure repetitive, painful and expensive diagnostic attempts...
  40. Baskin D, Stein F, Coats D, Paysse E. Recurrent conjunctivitis as a presentation of munchausen syndrome by proxy. Ophthalmology. 2003;110:1582-4 pubmed
    To report a case of Munchausen syndrome by proxy, which manifested as recurrent bilateral keratoconjunctivitis in an infant. Interventional case report...
  41. Lentze M. [With obscure symptoms always at the physician's. Is the "disease" of the child an invention of the mother?]. MMW Fortschr Med. 2003;145:15 pubmed
  42. Su E, Shoykhet M, Bell M. Severe hypernatremia in a hospitalized child: munchausen by proxy. Pediatr Neurol. 2010;43:270-3 pubmed publisher
    ..This case describes one of the ways that Munchausen syndrome by proxy can manifest with profound neurologic sequelae, and highlights the need for close observation and swift ..
  43. Eminson M, Jureidini J. Concerns about research and prevention strategies in Munchausen Syndrome by Proxy (MSBP) abuse. Child Abuse Negl. 2003;27:413-20 pubmed
    There would seem to be three motives for research into Munchausen Syndrome by Proxy (MSBP) abuse; first to enhance treatment; second to enhance our understanding of the psychopathology of those who carry out the abuse; and third to find ..
  44. Dyer C. Court dismisses appeals of two mothers. BMJ. 2004;328:1219 pubmed
  45. Harth W, Taube K, Gieler U. Facticious disorders in dermatology. J Dtsch Dermatol Ges. 2010;8:361-72; quiz 373 pubmed publisher
    ..This categorization is helpful in understanding the different pathogenic mechanisms and the psychodynamics involved, as well as in developing various therapeutic avenues and determining the prognosis. ..
  46. Lee J, Lin K, Lin J, Hsia S, Wu C. Non-accidental chlorpyrifos poisoning-an unusual cause of profound unconsciousness. Eur J Pediatr. 2010;169:509-11 pubmed publisher
    ..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.
  47. Maida A, Molina M, Erazo R. [Munchausen syndrome by proxy, an unusual presentation]. Rev Med Chil. 2001;129:917-20 pubmed
    ..She was discharged walking. The improvement during hospital stay confirmed the diagnosis of a Münchausen by proxy syndrome, mimicking a disabling neurological condition. ..
  48. Hall D. The future of child protection. J R Soc Med. 2006;99:6-9 pubmed
  49. Dyer C. GMC must consider case against paediatricians who suspected parents of fabricating child's illness. BMJ. 2006;332:1110 pubmed
  50. Birmingham C, Sidhu F. An algorithm for the diagnosis of Münchausen's syndrome in eating disorders. Eat Weight Disord. 2007;12:e75-7 pubmed
    ..We present an algorithm as an aid to the diagnosis of concurrent MS and ED. ..
  51. Olry R, Haines D. NEUROwords "Munchausen Syndrome by Proxy": Karl Friedrich Hieronymus, Baron von Münchhausen, hasn't got anything to do with it. J Hist Neurosci. 2006;15:276-8 pubmed
  52. Puri B. Munchausen syndrome by proxy in pregnancy. Int J Clin Pract. 2006;60:1527-9 pubmed
  53. Monteiro C, Trindade E, Monteiro F, Henriques I, Meireles E, Baía F, et al. Blood group-antigen profile predicted by molecular biology in Munchausen syndrome by proxy. J Lab Clin Med. 2004;144:319 pubmed