What is Munchausen syndrome by proxy?

Munchausen syndrome by proxy (MSBP) is a mental health problem in which you try to get sympathy by causing illness in someone else and then seeking medical care for that other person. Usually the victim is a child that is too young to talk or understand what is happening to them. Sometimes, victims are elderly or disabled adults.

What is the cause?

The exact cause of this disorder is not known. You are more likely to have this disorder if you:

• Have another mental health problem such as depression or substance abuse
• Have few long-term relationships and an unsatisfying family life
• Received a lot of medical care as a child or were abused as a child

You may feel insecure, uncertain, lonely, and depressed. You may believe that your ill child will bring a closer relationship with your spouse.

What are the symptoms?

Most people with MSBP are mothers of young children. However, fathers, day care providers, and healthcare providers may also have this disorder.

If you have this disorder, you may:

• Seem unusually calm and eager to have the victim undergo tests and surgery.
• Not want to leave the victim’s side and seem attentive to the point of being overprotective or obsessed with the child’s illness.
• Seem to need constant attention.
• Falsely accuse others of wrongdoing.
• Know a lot about medicine and hospitals.
• Have symptoms similar to the victim’s medical problems, or have a medical history of puzzling and unusual problems or a history of self-harm.
• Lie or make up problems or dramatic events such as house fires or car accidents.
• Have taken care of other children who had unexplained illness or who died.

Victims of MBSP may have problems that:

• Are very rare and dramatic.
• Start when the mother is with the child and go away when the mother is separated from the child.
• Do not respond to treatment and have no clear diagnosis.

How is it diagnosed?

MSBP may be suspected by healthcare providers who care for the victims. MSBP is diagnosed by gathering evidence, such as filming you abusing the victim in a hospital room. You may not get help until you are caught by the police.

How is it treated?

Once the victim is safe, MSBP may be treated with therapy.

• Behavior therapy helps you recognize that the way you act affects others. This can help you change problem behaviors.
• Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.

There are no medicines known to help MSBP.

Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others.

If you suspect that someone you know has MSBP, get help right away. If you’re not sure who to call, look in the phone book for listings under child abuse, Department of Social Services, or Department of Human Services.

You can also call your local law enforcement agency if you think the victim is in immediate danger. For more information, contact:

• National Alliance on Mental Illness (NAMI)
  800-950-6264
  http://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/