Overprotective mother or Munchausen syndrome by proxy? Characteristics of the disease based on a literature review

Background: Munchausen syndrome by proxy (MSBP), first described by Meadow in 1977, is a mental disorder in which the caregiver or parent (usually the mother) causes the child to become ill to attract attention. The disease most often affects women, with sufferers usually appearing very caring and involved in the treatment. However, they harm the child, leading to physical and mental damage and sometimes death. The caregiver fabricates disease symptoms and will report false symptoms in the child or directly cause the disease. Moreover, they agree to diagnostic procedures and numerous medical interventions and deny the cause of the disease, and after separation from the caregiver, the child’s condition improves. Aim of the study: The purpose of this review is to present a characterization of MSBP, taking into account its diagnostic difficulties, treatment methods, and consequences for the child. Material and methods: All relevant publications were retrieved from the PubMed and Google Scholar databases, with keywords including “Munchausen syndrome by proxy” (PubMed – 780 results; Google Scholar – 10500 results), “Munchausen syndrome by proxy diagnosis” (PubMed – 612 results; Google Scholar – 7940 results), and “Munchausen syndrome by proxy treatment” (PubMed – 301 results; Google Scholar – 8210 results), with 53 papers selected. Half of the studies had been published in the last five years.Results: The main MSBP diagnostic difficulties include the low age of the victims and the frequent changes of treatment centers, which often worsen the child’s condition. According to some scientists, MSBP psychotherapy treatment may produce the expected results for the patient and child. Children can die or develop future mental and physical problems as a result of their parent’s disorder.Conclusions: MSBP is a disease that is usually severe and difficult to diagnose and treat, and to which children fall victim. In order to diagnose MSBP, attending physician vigilance is essential.