[Somatic disease or Munchausen syndrome by proxy? Mother's or child's disease? Diagnostic controversies]. 2007

Małgorzata Janas-Kozik, and Joanna Albert, and Ewa Kresimon, and Magdalena Stokowacka-Zakrzewska, and Karina Wawrzyniak
Oddział Psychiatrii i Psychoterapii Wieku, Rozwojowego Centrum Pediatrii im. Jana Pawła II w Sosnowcu. mjkozik@o2.pl

INTRODUCTIONn: The Munchausen Syndrome by Proxy occurs when parents make a child believe he or she suffers from a disease while in fact this is not true. A medical diagnosis ruling out a possible disease of the child does not calm the parents down and only confirms--in their belief--the doctor's incompetence which in turn makes them seek a second opinion. This may be repeated over and over again and be accompanied by administration of medicines, overprotection, introducing a diet, limiting exercise as well as limiting motoric and mental development. OBJECTIVE Authors present diagnostic difficulties in diagnosing the Munchausen syndrome. METHODS A 6-year old girl was hospitalized for the first time at the Developmental Age Psychiatry and Psychotherapy Ward of the John Paul II Pediatric Center in Sosnowiec, Poland (until then she had received psychiatric treatment at the Center on an outpatient basis only). Medical history provided by her mother as well as supplied documents show numerous hospitalizations at Pediatric Wards since the girl was 6 weeks old due to intensified vomiting and frequent diarrheas. Since the age of 4, the girl has been provoking vomiting as well as temporarily refusing meals and liquids. CONCLUSIONS Authors present diagnostic difficulties in diagnosing the Munchausen syndrome mainly caused by discharging the patient from the Ward on her mother's request as well as non-specific nature of the symptoms.

UI MeSH Term Description Entries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016735 Munchausen Syndrome by Proxy A phenomenon in which symptoms of a disease are fabricated by an individual other than the patient causing unnecessary, and often painful, physical examinations and treatments. This syndrome is considered a form of CHILD ABUSE, since another individual, usually a parent, is the source of the fabrication of symptoms and presents the child for medical care.

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