MUNCHAUSEN-SYNDROME BY PROXY

Munchausen syndrome by proxy is a form of child abuse in which the mot her makes up or causes symptoms in her child, leading physioians to us e unnecessary investigations and treatments. The symptoms are unusual, unexplained, and protracted. Treatments are ineffective or poorly tol erated. Symptoms occur only when the mother is present. The mothers ca n be categorized into three groups based on their behavior. Active ind ucers are most likely to put their child in danger, as early as the fi rst year of life. Doctor addicts project their hypochondria on their c hild, insistently asking physicians to confirm the child's imaginary d isease. Help seekers exaggerate their child's symptoms and often feel that they are unable to cope with their child's needs. Psychotherapy h as little effect on maternal behavior. Steps should be taken to protec t the child The health status of siblings should be evaluated, and the family should receive long-term followup.