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Diagnosis and Treatment of the Factitious Disorder on Another, Previously Called Munchausen Syndrome by Proxy

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Abstract

In the factitious disorder (FD) on another, formerly called Munchausen syndrome by proxy (MSbP), one of the parents, the mother in 95% of the cases, fabricates or invents clinical symptoms in her child with the intention of convincing doctors and pediatricians that the child is sick. In the chapter on addictive disorders of the 5th Edition of Diagnostic and Statistical Manual of Mental Disorders, the gambling disorder was included, opening up the possibility of incorporating other problematic addictive risk behaviors in the same chapter. In this work, we intend to provide current data for improving the detection and treatment of MSbP as addictive disorder. Four clinical cases of MSbP studied by the authors are described. Retrospective analysis and semi-structured interviews were carried out to assess the psychopathological profile of MSbP. The four perpetrating mothers in the cases studied had a common and characteristic psychopathological profile. These mothers falsified diseases in their victimized children, obtaining rewards from the hospitalization of their children. The continuous alteration of the mother-to-child attachment with a pathological bond, which is at the basis of therapeutic intervention together with the mothers’ emotional confrontation with reality, is verified. It is proposed that the psychopathological profile of the perpetrator of FD on another corresponds to an addictive disorder, in which the hospital context is compulsively sought, providing a high degree of gratification and reward.

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Authors and Affiliations

  1. Depto. de Fisiología y Farmacología, Facultad de Medicina, Universidad de Salamanca, 37005, Salamanca, Spain

    M. Lopez-Rico, J. J. Lopez-Ibor Jr, D. Crespo-Hervas, A. Muñoz-Villa & J. L. Jimenez-Hernandez

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  1. M. Lopez-Rico
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  2. J. J. Lopez-Ibor Jr
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  3. D. Crespo-Hervas
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Not applicable as no new clinical data was collected after 1987.

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At the time of the retrospective analysis carried out here, we no longer had access to the patients.

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J. J. Lopez-Ibor Jr. passed away in 2015.

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Lopez-Rico, M., Lopez-Ibor, J.J., Crespo-Hervas, D. et al. Diagnosis and Treatment of the Factitious Disorder on Another, Previously Called Munchausen Syndrome by Proxy. SN Compr. Clin. Med. 1, 419–433 (2019). https://doi.org/10.1007/s42399-019-00057-6

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