If you want to save this information but don't think it is safe to take it home, see if a trusted friend can keep it for you. Plan ahead. Know who you can call for help, and memorize the phone number.
Be careful online too. Your online activity may be seen by others. Do not use your personal computer or device to read about this topic. Use a safe computer such as one at work, a friend's house, or a library.
syndrome by proxy (MSBP) is a mental health problem in which a caregiver makes
up or causes an illness or injury in a person under his or her care, such as a child, an elderly adult, or a person who has a disability. Because vulnerable people
are the victims, MSBP is a form of
child abuse or elder abuse.
Note: Since most cases of MSBP are between a
caregiver (usually a mother) and a child, the rest of this topic will describe that relationship. But it is important to remember that MSBP can involve any vulnerable person who has a caregiver.
The caregiver with MSBP
Victims are most often small children. They may get
painful medical tests they don't need. They may even become seriously ill or
injured or may die because of the actions of the caregiver.
Children who are victims of MSBP can have lifelong physical and emotional
problems and may have
Munchausen syndrome as adults. This is a disorder in
which a person causes or falsely reports his or her own symptoms.
aren't sure what causes it, but it may be linked to problems during the
abuser's childhood. Abusers often feel like their life is out of control. They
often have poor self-esteem and can't deal with stress or anxiety.
The attention that caregivers get from having a sick child may encourage
their behaviour. Caregivers may get attention not only from doctors and nurses
but also from others in their community. For example, neighbours may try to help
the family in many ways—such as by doing chores, bringing meals, or giving
A person with MSBP often:
Checking a child's medical records for past tests, treatments, and hospital stays may help a doctor or nurse find out if a health problem is real.
Doctors or nurses may suspect a problem when:
Child protective services, law enforcement, and doctors are all involved in treatment for Munchausen
syndrome by proxy. Caregivers who have this condition need long-term
counselling. They may resist treatment or deny that
there is a problem. Medicines are used only when the caregiver has another
health problem, such as anxiety disorder, along with MSBP.
after treatment, caregivers may repeat their behaviour. So doctors, counsellors,
and family members need to closely watch how the caregiver interacts with his or her
For victims, the first step is to protect the child by
moving him or her into safe custody. Then a doctor will monitor the child for symptoms. Most
of the time, the child's symptoms stop after the child is away from the
caregiver. Some children need counselling or other help.
MSBP is child abuse. If you suspect that a child is a
victim, don't confront the suspected caregiver. It might make the problem
worse. Instead, think about these options:
Learning about Munchausen syndrome by proxy:
Many of the resources below provide help 24 hours a day, 7 days a week in multiple languages. In an emergency, call 911.
Check your local phone book or provincial or territorial website.
Other Works Consulted
Dubowitz H, Lane WG (2011). Factitious disorder by proxy (Munchausen syndrome by proxy). In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 146–147. Philadelphia: Saunders.
McDermott BE (2008). Factitious disorder and malingering. In RE Hales et al., eds., The American Psychiatric Publishing Textbook of Psychiatry, 5th ed., pp. 643–664. Washington, DC: American Psychiatric Publishing.
Wang DL, et al. (2009). Factitious disorder. In BJ Sadock et al., eds., Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th ed., vol. 1, pp. 1949–1964. Philadelphia: Lippincott Williams and Wilkins.
ByHealthwise StaffPrimary Medical ReviewerKathleen Romito, MD - Family MedicineDonald Sproule, MDCM, CCFP - Family MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerLisa S. Weinstock, MD - Psychiatry
Current as ofNovember 20, 2015
Current as of:
November 20, 2015
Kathleen Romito, MD - Family Medicine
& Donald Sproule, MDCM, CCFP - Family Medicine & Adam Husney, MD - Family Medicine & Lisa S. Weinstock, MD - Psychiatry
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