Elsevier

Child Abuse & Neglect

Volume 18, Issue 9, September 1994, Pages 773-788
Child Abuse & Neglect

Spotlight on practice
Munchausen syndrome by proxy: A study of psychopathology

https://doi.org/10.1016/0145-2134(94)00044-1Get rights and content

Abstract

Munchausen Syndrome by Proxy (the fabrication of illness by a mother in her child) is often a serious form of child abuse that has been recognized increasingly over recent years. Approximately one-half of the mothers in this study had either smothered or poisoned their child as part of their fabrications. Lifetime psychiatric histories are reported for 47 of the mothers. Thirty-four had a history of a Factitious or Somatoform disorder, 26 a history of self harm, and 10 of alcohol or drug misuse. Nine mothers had a forensic history independent of convictions related to child abuse. Nineteen of these mothers were interviewed from 1–15 years after the original fabrications. The most notable psychopathology was the presence of a personality disorder in 17 of the mothers, which were predominantly Histrionic and Borderline types. Most subjects, however, met the criteria for more than one category of personality disorder.

Résumé

French abstract not available at time of publication. This abstract will appear in a future issue of the Journal.

Resumen

El Síndrome de Munchausen por Poder (la invención de una enfermedad por una madre en su hijo) es a menudo una forma severa de abuso contra los niños que ha sido reconocida como en aumento en los años recientes. Aproximadamente la mitad de las madres en este estudio habian asfixiado o envenenado a su hijo como parte de sus invenciones. Se han reportado historias psiquátricas de 47 de las madres. Treinta y cuatro tenían historias de un desórden Ficticio o Somatoforme, 26 historia de autoagresión, y 10 de mal uso del alcohol o las drogas. Se entrevistaron a diecinueve de éstas madres de 1 a 15 años después del invento. La psicopatología más notable fue la presencia de un desórden de personalidad en 17 de las madres que eran predominantemente tipos Histrionicos y Fronterizos. La mayoría de las sujetos, sin embargo, llenan los criterios para más de una categoria de desóorden de la personalidad.

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      Citation Excerpt :

      In this study of 41 children (15 with failure to thrive through active withdrawal of food or alleged allergies) and 26 victims of fabricated or induced illness, six mothers had a factitious disorder, one had hypochondriasis, and 16 had a history of depression. Somatoform and factitious disorders are over-represented among perpetrators: in a study of 47 mothers, 30 of whom were active inducers, Bools and colleagues31 noted that the most probable diagnosis for 34 (72%) participants was a somatoform disorder (of whom 25 [74%] had a factitious disorder with physical symptoms). Similar findings were reported in a more recent study of 28 mothers (all with evidence of fabrication or induction of illness in children),24 in which somatoform disorders were reported in 57% of participants and factitious disorders in 64%, with co-occurrence of these disorders in 39% of participants.

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    The first and second authors were supported by a grant (LE 121) from the Yorkshire Regional Health Authority.

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