Munchausen's syndrome by proxy and its professional participants
B. J. Zitelli, M. F. Seltman and R. M. Shannon
Physicians and legal and protective service agencies may unwittingly
participate in Munchausen's syndrome by proxy (MSP) when they fall to
recognize MSP, treat the true disorder, and effect a favorable outcome for
the child. Five patients with MSP are described, emphasizing a variety of
presentations, often with a delay in diagnosis. In addition, features in
the family unit are identified to aid in early recognition of the disorder,
and a management protocol used at Children's Hospital of Pittsburgh is
presented. Finally, the need for better care, recognition, and reporting to
help determine the true incidence of the disorder and aid in educating
involved professionals is emphasized.
