Munchausen syndrome by proxy : controversies

Abstract EN

Objective: Munchausen syndrome by proxy (MSbP) is a controversial diagnostic entity and needs further research.

Methods: A computer search of the past two decades was conducted to identify relevant literature on MSbP abuse in children.

Results: Despite DSM-IV diagnostic criteria for MSbP abuse, the diagnosis of MSbP has been challenged and politicized in highly litigant conscious western societies.

This volatile situation galvanized further when mothers accused of intentionally murdering their children were released from the prisons and likewise some mothers were detained in prisons when they did not intentionally kill their children, both types of judicial decisions were made in the shadow of MSbP.

In the absence of truth and confession, it is difficult to decide whether or not the child died accidentally.

Social custody of surviving children also evokes considerable media attention and hence physicians are apprehensive to take part in child abuse protection and related legal issues.

Conclusion: The diagnosis of MSbP becomes difficult in case the mother murders the child and then defends herself.

Physicians should essentially make early diagnosis of factitious disorders in children in order to both offer comprehensive management and protect them from further abuse.