Friday, March 7, 2014

Lexicon of Madness -- Munchausen's Syndrome by proxy

Munchausen's Syndrome by proxy: In Factitious Disorder, a person intentionally feigns or produces symptoms so as to gain admission to a hospital, receive attention and treatment from a physician, and more generally "assume the sick role." Factitious Disorder has also been called Munchausen's Syndrome, after a 17th Century German baron and soldier known for telling tall tales. There are no external incentives for his behavior. Patients may assiduously study various physical disorders in order to more effectively mimic their presentation. They might ingest small amount of toxic substances or rub fecal matter into a cut in order to produce an infection that requires medical attention. They might feign severe abdominal pain and, after a series of negative medical tests, agree readily to exploratory abdominal surgery. Their surgeons may observe a herringbone pattern of scarring from past surgeries. A significant percentage of patients with factitious disorder eventually die, from either self-poisoning or complications from unneccessary medical procedures. These "professional patients" can become demanding or even litigious, especially when they feel that their claims are not believed. Many of these patients underwent extensive or repeated medical treatment during childhood, often as the result of physical abuse or neglect. In Factitious Disorder by proxy (or, Munchausen's Syndrome by proxy), a caregiver, almost always the mother, feigns or induces illness in her young child. In that way, she indirectly assumes the "sick role" and garners sympathetic care and attention. While presenting as the "ideal parent," she can also be quite demanding and controlling, insisting on invasive medical tests and risky procedures. Many of these mothers have had nursing training, or claim some kind of medical background. Upon hospitalization, the child often improves, unless the mother continues administering toxins during her visits. Several pediatric hospitals utilize hidden cameras in the rooms of children whose mothers are suspected of Muchausen's Syndrome by proxy.

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