Munchausen Overview

Researchers aren't sure exactly what causes Munchausen syndrome, but they believe the risks include:

Most people who have the condition are either young or middle-aged, but Munchausen syndrome can occur at any age.

People with Munchausen syndrome will go to great lengths to feign illness. They might pretend to be sick by tampering with instruments (for example, heating a thermometer) or altering blood or urine samples, or they might actually cause symptoms by injecting themselves with foreign substances (such as toxins) or taking unnecessary medications.

Some of the symptoms of Munchausen syndrome include:

Munchausen syndrome can lead to real health problems from taking medicines and undergoing unnecessary procedures. It also can increase the risk of suicide, interfere with work and family relationships, and can even lead to death.

In the late 1970s, a British pediatrician named Roy Meadow published an account of two baffling medical cases. In one case, a 6-year-old girl named Kay had been admitted to the hospital 12 times for a urinary tract infection and had been treated with eight different antibiotics -- all unsuccessfully. In the other case, a 14-month-old boy named Charles had been hospitalized many times with drowsiness and vomiting that had no apparent medical cause. Meadow ultimately discovered that the two cases, although they appeared different, had a lot in common. Kay's mother had altered her urine samples to make it appear as if the child were sick. Charles's mother had induced his illness by feeding him large quantities of salt (he eventually died).

Meadow called this condition, in which caregivers knowingly falsify information or inflict harm on their children to garner sympathy, Munchausen syndrome by proxy. Proxy means "through a substitute." The caregiver, not the sick person, is the one faking or causing the illness.

Munchausen syndrome by proxy has also been called Polle syndrome, for Baron von Munchausen's son Polle, who reportedly died under mysterious circumstances around the time of his first birthday. However, some experts say that historical information is incorrect, and the term is no longer used today.

This condition is very rare -- there are only about 1,000 cases a year, according to best estimates. The most common scenario is a mother pretending that her child is sick, or making her child sick because she craves the sympathy she receives as a result. The mother might change test results (for example, by adding a foreign substance to a urine test), inject chemicals into the child, withhold food, suffocate the child or give drugs to cause vomiting. Then the mother will insist that the child go through many tests or procedures to treat the supposed problem. Because the victim is a child, Munchausen syndrome by proxy is considered a form of child abuse.

Someone who has Munchausen syndrome by proxy may be seeking attention because she was abused or lost a parent as a child, or is going through difficult marital problems or another major life stress. Being seen as the caring parent by hospital staff is a way to earn praise that the sufferer might not have garnered otherwise.

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Signs of Munchausen syndrome by proxy include:

V­ictims of Munchausen syndrome by proxy have to go through unnecessary tests and treatments that can be painful or even dangerous. Because the caregiver seems so genuinely concerned, it's often hard for doctors to spot the problem before it's too late. This difficulty discerning Munchausen syndrome by proxy from real illness has led to a number of false allegations against parents.

In the 1990s, Dr. David Southall of England conducted an experiment using hidden video surveillance in hospital rooms to catch those suspected of having Munchausen syndrome by proxy. His video cameras captured horrifying images of mothers smothering and poisoning their children. Of the 39 suspected abusers he videotaped, 34 were captured on tape hurting their children and five later admitted to killing their children.

Although Southall was hailed as a champion of children in some­ circles, he was vilified as an enemy of mothers in others. A number of parents were sent to prison, and some say falsely accused, based on evidence he provided. In 2004, Southall was found guilty of serious professional misconduct after falsely accusing a man of murdering his children, and was temporarily banned from working with child abuse victims.

Both types of Munchausen syndrome are difficult to treat because people who have these conditions are unwilling to admit they have a problem. Doctors have to investigate the patient's medical history and perform medical tests to confirm that the problem is psychological and not than physical.

Treatment for Munchausen syndrome usually involves psychiatric counseling to change the thoughts and behaviors that are causing the condition. Sometimes medication can help ease depression or anxiety if those are factors.

With Munchausen syndrome by proxy, it's important to get the child away from the caregiver before any further harm is done. The child may need treatment both for the physical complications of having undergone unnecessary tests and procedures, and for the psychological scars of abuse. About 10 percent of children who have been victims of Munchausen syndrome by proxy will die. Others could go on to develop Munchausen syndrome when they grow up.

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