Munchausen syndrome by proxy is a mental health disorder in which a caregiver, most often a mother, fabricates false symptoms or causes real symptoms in a child or adult victim to make it appear as if the victim has a real health problem, be it physical or mental.
These actions are often the result of maladjustment disorder or excessive attention seeking by the caregiver. In addition to being a disorder, Munchausen syndrome by proxy is also considered a very serious form ofchild abuse.
Munchausen syndrome and Munchausen syndrome by proxy are now classified as "factitious disorder imposed on another" or FDIA in theDiagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). This change represents the belief that this disorder describes a pattern of behavior rather than an underlying psychiatric syndrome.
Although FDIA is rare, the mortality rate is worrisome. Between 6 and 10 percent of all FDIA cases will result in death, making it very lethal.form of abuse.
Key facts and examples of child abuse cases
Munchausen symptoms for power
Signs and symptoms of FDIA are likely to be present in both the caregiver and the child or adult victim. It is important for the doctor to watch for signs and symptoms on both parties and follow up on any concerns.
In the caregiver, it is important to look for the following signs:
- caretaker deception
- The reports of caregivers are different from those of medical personnel.
- The caregiver has a medical background and can work in a medical environment.
- The caregiver wants to be seen as "good" at what they do
- The caregiver routinely seeks the approval and attention of medical personnel
- Caregiver's refusal to leave the victim's side when assessing the victim
- The victim's medical history is patchy, vague, or inconsistent
- Recommendations for invasive diagnostic and surgical procedures are accepted without question or concern from the caregiver.
In addition, a caregiver often requests a second opinion, other interventions, and additional procedures. Frequently present in the caregiver are bad relationships with the family and/or lack of relationship with friends or other social networks.
Warning signs in a child or adult victim may include:
- Reported medical problems that do not respond to treatment
- Symptoms or signs of disease only appear in the presence of the caregiver
- Signs and symptoms may improve under medical care
- History of multiple and repeated injuries, illnesses, medical procedures, surgeries, and/or hospitalizations
- Unusual presentation of a disorder or disease involving normal examination and observation by medical personnel
- Second absent parent, in the case of a child victim
The exact cause of FDIA or Munchausen syndrome by proxy is unclear. However, experts say that both biological and psychological factors play a role in the development of this disorder.
One theory suggests that people with FDIA experienced a history of neglect or psychological, sexual, or emotional abuse as children. The caregiver may also have a psychiatric disorder, such as personality disorder, bipolar disorder, anxiety, or depression. Other theories point to the loss of a parent at an early age or great stress.
Munchausen types by proxy
Munchausen syndrome by proxy always involves a caregiver and a victim, usually a child or another adult. Munchausen syndrome, on the other hand, is when a person presents themselves to others, more specifically medical personnel, as sick.
Both are considered factitious disorders with Munchausen syndrome by proxy classified as factitious disorder imposed on another (FDIA) and Munchausen as factitious disorder self-imposed or FDIS.
In the FDIA, “other” can be a child of the caregiver, such as mother and child, or it can be another adult that the perpetrator is caring for.
What is Munchausen syndrome (self-imposed factitious disorder)?
The diagnosis of Munchausen syndrome by proxy is challenging for doctors because of all the dishonesty displayed by the adult caregiver. A basic principle in the diagnosis of this disorder is that deception is present in all cases.
A person with FDIA will misrepresent the history and symptoms of the adult or child victim, eventually leading to overtreatment and unnecessary medical procedures.
There is a set of criteria used to diagnose FDIA or Munchausen syndrome by proxy. To meet a clinical diagnosis, the following four criteria must be met:
- The abuser or caregiver engages in misrepresenting physical or psychological signs or symptoms, or inducing injury or illness in another person.
- The person presents the victim to others as ill, injured, or disabled.
- Deceptive behavior is present in the absence of external incentives.
- The behavior is not better explained by another mental disorder, such as a Delusional Disorder or another Psychotic Disorder.
Munchausen treatment by proxy
Treatment of FDIA or Munchausen syndrome by proxy usually requires treatment of both the adult and the child or adult victim. That being said, it can be difficult to get the perpetrator to seek treatment, as he is often unwilling to admit to her behavior or seek treatment. Often it is an intervention on the child's behalf by a doctor or other protective agency that forces the issue.
In the event that a parent/guardian is willing to receive help and is not being investigated for abuse, the treating physician should refer them to individual or family therapy. The doctor and mental health specialists should work together on a treatment plan for the family.
If the child or adult victim is removed from the perpetrator's care, treatment may involve medical and psychological interventions. FDIA victims will need psychotherapy or psychiatric treatment to help them understand and deal with the abuse they have been subjected to by a caregiver or parent.
They may also need ongoing medical follow-up to monitor any physical damage inflicted by the caregiver. The doctor and mental health specialists should form a multidisciplinary hospital or community child protection team to treat the victim.
The perpetrator or offending parent may face criminal charges related to the abuse. Treatment of the caregiver/perpetrator will depend on the legal issues related to the case and other psychiatric conditions.
Treating the Effects of Childhood Trauma
FDIA or Munchausen syndrome by proxy is a serious form of child abuse that requires immediate intervention by Child Protective Services and medical personnel.
mental health professionalsMunchausen treatment specialists by proxy are often called in to treat the individual exhibiting such behavior. However, Child Protective Services must also take legal action (such as removing the child from adult custody) after investigating the matter.
In any case, it is necessary that both the aggressor and the victim receive adequate mental health care to help them cope and overcome the situation.traumaof such a relationship.
That being said, if a family member of the perpetrator or child needs support, information or other services, contacting a specialist can help them deal with the situation.
A word from Verywell
If you have questions about the FDAA, seek medical and psychiatric help immediately. If you suspect that someone you know is engaging in behavior patterns associated with FDIA or Munchausen syndrome by proxy, contact your local Child Protective Services agency immediately. If you think a child is in imminent danger, call 911. In some cases, FDIA can be serious and life-threatening.
If you or a loved one is battling Munchausen syndrome by proxy, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Hotlineat 1-800-662-4357 for information on treatment and support centers in your area.
For more mental health resources, check out ourNational Database of Support Lines.
Verywell Mind only uses high-quality sources, including peer-reviewed studies, to support the facts in our articles. read ourpublishing processfor more information on how we verify and keep our content accurate, reliable and trustworthy.
Faedda N, Baglioni V, Natalucci G, et al.Don't judge a book by its cover: Factitious disorder imposed on children - report of 2 cases.front pediatrics2018;6:110. doi:10.3389/fped.2018.00110
chico bMunchausen for power: five basic principles. Annals of Pediatrics and Child Health.2020.(Video) Symptoms of Munchausen by Proxy?
Comert I, Ugras S, Islek D, et al.A review of the Munchausen Syndrome by proxy: form of child abuse. nothing Forensic Criminol Int J.2018;6(2):86–88. DOI:10.15406/frcij.2018.06.00188
Stirling j.Beyond Munchausen Syndrome by Proxy: Identifying and Treating Child Abuse.PediatricsMay 2007, 119(5) 1026-1030; DOI: https://doi.org/10.1542/peds.2007-0563.
OfSara Lindberg, M.Ed.
Sara Lindberg, M.Ed., is a freelance writer focusing on mental health, fitness, nutrition, and parenting.
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Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.Is Munchausen by proxy a real disorder? ›
Munchausen syndrome by proxy (MSP) is a mental illness. It is also a form of child abuse. It affects caregivers, especially caregivers of children. It is also known as factitious disorder by proxy.What is Munchausen syndrome by proxy treatment? ›
How is Munchausen syndrome by proxy treated? Child protective services, law enforcement, and doctors are all involved in treatment for Munchausen syndrome by proxy (MSBP). Caregivers who have this condition need long-term counselling. They may resist treatment or deny that there is a problem.What is an example of Munchausen syndrome? ›
Munchausen syndrome (factitious disorder imposed on self) is when someone tries to get attention and sympathy by falsifying, inducing, and/or exaggerating an illness. They lie about symptoms, sabotage medical tests (like putting blood in their urine), or harm themselves to get the symptoms.What are the signs and symptoms of Munchausen syndrome? ›
- making frequent visits to hospitals in different areas.
- claiming to have a history of complex and serious medical conditions with no or little supporting evidence – people often claim they've spent a long time out of the country.
- having symptoms that do not match test results.
Munchausen syndrome is a factitious disorder, a mental disorder in which a person repeatedly and deliberately acts as if they have a physical or mental illness when they are not really sick. Munchausen syndrome is considered a mental illness because it is associated with severe emotional difficulties.What is Munchausen called now? ›
Factitious disorder imposed on another (previously called Munchausen syndrome by proxy) is when someone falsely claims that another person has physical or psychological signs or symptoms of illness, or causes injury or disease in another person with the intention of deceiving others.What is the root cause of Munchausen syndrome? ›
Munchausen syndrome may be caused by parental neglect and abandonment, or other childhood trauma. As a result of this trauma, a person may have unresolved issues with their parents that cause them to fake illness.What is one famous case of Munchausen by proxy? ›
Gypsy-Rose Blanchard (see Murder of Dee Dee Blanchard). Gypsy-Rose was Dee Dee's proxy and suffered over a decade of medical abuse before relenting and killing Dee Dee with the help of her autistic boyfriend, Nick; Gypsy-Rose and Nick were later convicted and sent to prison.
- a history of repeated injuries, illnesses, or hospitalizations.
- symptoms that don't quite fit any disease.
- symptoms that don't match test results.
- symptoms that seem to improve under medical care but get worse at home.
They made limited attempts to alert others, with little success. Subjects reported significant emotional and physical problems in childhood, and problems in adulthood including insecurity, reality-testing issues, avoidance of medical treatment and posttraumatic stress symptoms.Can Munchausen by Proxy lead to death? ›
What Is the Outlook for Victims of People With Munchausen Syndrome by Proxy? This disorder can lead to serious short- and long-term complications, including continued abuse, multiple hospitalizations, and the death of the victim. (Research suggests that the death rate for victims of MSP is about 10%.)What crime is Munchausen syndrome? ›
Munchausen syndrome by proxy (MSBP) is a form of child abuse that describes children whose parents or caregivers invent illness stories and substantiate the stories by fabricating false physical signs.Who are the most common victims of Munchausen syndrome by proxy? ›
The syndrome involves one person artificially producing or faking symptoms in another person so as to attract attention of medical personnel. Typically, the proxy is a parent and the victim is his or her child.What does a person with Munchausen syndrome pretend to be? ›
About Munchausen syndrome
Munchausen syndrome (also known as factitious disorder) is a rare type of mental disorder in which a person fakes illness. The person may lie about symptoms, make themselves appear sick, or make themselves purposely unwell.
Somatic symptom disorder. Illness anxiety disorder, sometimes called hypochondriasis or health anxiety, is worrying excessively that you are or may become seriously ill.What is it called when you make up stories in your head and believing them? ›
Delusional disorder is a type of mental health condition in which a person can't tell what's real from what's imagined. There are many types, including persecutory, jealous and grandiose types. It's treatable with psychotherapy and medication.What is it called when you self diagnose yourself with everything? ›
Psychologists call this “cyberchondria” for obsessing on investigating health symptoms on the Internet. Think of it as online hypochondria.What is another name for Munchausen syndrome? ›
Fabricated or Induced Illness by Carers has also been referred to as Munchausen by Proxy; Munchausen by Proxy Syndrome; Meadow's Syndrome; Factitious Disorder by Proxy; and Fictitious Disorder by Proxy.Who gets Munchausen? ›
The condition is thought to be most common in white men aged between 30 and 50. It is unclear why this is the case. The causes of Munchausen's syndrome are largely unknown.
The Devastating True Story Of Gypsy Blanchard
The murder of American woman Dee Dee Blanchard in 2015, is one of the most famous cases of Munchausen syndrome by proxy ever, and a new documentary Gypsy's Revenge revisits the murder, the familial abuse and all the people involved, three years after the crime took place.
Munchausen syndrome by proxy (MSP) is a complex type of emotional abuse that may overlap with other forms of child abuse. The syndrome was first identified in pediatric settings where some mothers were discovered to be creating the appearance that their children were ill (Money & Werlwas, 1976; Meadow) 1977).What are some famous cases of Munchausen? ›
Famous Munchausen Cases
Perhaps the most publicized recent case is that of Dee Dee Blanchard. Blanchard kept her daughter Gypsy in a wheelchair throughout her life. In addition, Blanchard claimed Gypsy had leukemia, muscular dystrophy, and other ailments. Gypsy was convicted for the murder of her mother in 2015.
Munchausen's syndrome is different than hypochondria (health anxiety) or malingering. Hypochondria is a psychiatric disorder where a person has a fear of illness. They interpret normal body functions as signs of major illness. Malingering is faking illness to gain a material benefit.Can you go to jail for Munchausen? ›
Munchausen Syndrome by Proxy allegations are extremely serious. If charged with child abuse, a parent may lose custody of his or her child. If convicted, serious criminal penalties will follow, including long-term imprisonment and heavy fines.Is Munchausen inherited? ›
Munchausen syndrome is not genetic or hereditary, so if the disorder runs in a family it is not due to genes, but may more likely be due to the upbringing or the environment a child has experienced.Is Munchausen syndrome medical neglect? ›
The condition widely known as Munchausen syndrome by proxy comprises both physical abuse and medical neglect and is also a form of psychological maltreatment.Can you sue for Munchausen syndrome? ›
Munchausen syndrome may come up in court cases involving insurance fraud or medical malpractice. Because Munchausen syndrome is closely related to Munchausen by proxy, a medical expert may also bring up a person's history of Munchausen syndrome in cases involving child custody or abuse.Which profession is common among mothers with Munchausen syndrome by proxy? ›
Factitious Disorder by Proxy
Some of the persons with this syndrome have had medical training in a health-related profession, such as nursing,84,85 and they use their medical knowledge to create “illness” in their child. The mother is usually at the infant's or young child's bedside.
The behavior usually begins before 20 years old and is diagnosed between 35 and 39 years old. Twice as many men as women are affected. Patients' entire adult lives may consist of trying to gain admission to hospitals and then steadfastly resisting discharge.
We know that the mean age of onset of adult FD is most commonly in the patient's early 20s51 and up to perhaps half the cases may begin in adolescence.How can you tell if someone is faking insanity? ›
However, some indications of faking mental illness can include exaggerating any existing symptoms, making up medical or psychological histories, causing self-harm, tampering with medical tests, or malingering.What did Gypsy Rose mom do to her? › What are some famous cases of Munchausen by proxy? ›
The story of Marybeth Tinning and her nine deceased children goes down as one of the most puzzling and fatal cases of Munchausen's Syndrome by proxy in the history of the disorder.How many surgeries did Gypsy Rose Blanchard have? ›
How many surgeries did you have?" About 30 different procedures, Blanchard responded, including multiple eye, leg and throat surgeries. Blanchard's salivary glands were also removed. "You have been cut open.What was Gypsy Rose diagnosed with? ›
There was no sign of her daughter, Gypsy Rose, who, according to Blanchard, had chronic conditions including leukemia, asthma, and muscular dystrophy, and who had the "mental capacity of a 7-year-old due to brain damage" as the result of premature birth.How long is Gypsy in jail? ›
Blanchard is serving a 10-year prison sentence for her role in the murder of her mother, Dee Dee Blanchard, in June of 2015 in Springfield.How do you treat someone with Munchausen? ›
- Medications to treat associated mental health illnesses such as depression or anxiety. ...
- Cognitive behaviour therapy (CBT) may help to change the person's beliefs and actions. ...
- Avoiding unnecessary tests and surgeries is important to reduce the risk of complications.
Factitious disorder imposed on another (FDIA) formerly Munchausen syndrome by proxy (MSP) is a mental illness in which a person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick.What is Munchausen's called now? ›
Fabricated or Induced Illness by Carers previously known as Munchausen Syndrome by Proxy is not a condition, psychiatric disorder or diagnosis that a parent or carer has. Fabricated or Induced Illness by Carers is what a parent or carer does to a child.