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Munchausen syndrome by proxy (MSBP): a review regarding perpetrators of factitious disorder imposed on another (FDIA)

Nuzhat Abdurrachid1, João Gama Marques1,2

  • 1Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.

CNS Spectrums
|August 11, 2020
PubMed

Insights

Munchausen syndrome by proxy (MSBP), a form of abuse through illness falsification, predominantly involves female perpetrators. Awareness of perpetrator characteristics aids clinical identification of this rare abuse.

Area of Science:

  • Medical Psychology
  • Child Abuse Research
  • Forensic Psychiatry

Background:

  • Munchausen syndrome by proxy (MSBP) is a recognized but controversial term for abuse via illness falsification.
  • Current clinical practice favors terminology emphasizing the victim, moving away from MSBP.
  • Factitious disorder imposed on another (FDIA) is a related diagnosis for perpetrators.

Purpose of the Study:

  • To identify common characteristics of perpetrators in case reports specifically labeled as MSBP.
  • To analyze data from PubMed-published literature over the last 15 years.

Main Methods:

  • Systematic review of 108 articles, including 81 case reports, identified via PubMed.
  • Data extraction focused on perpetrator demographics, psychiatric diagnoses, familial context, occupation, falsification methods, outcomes, and recurrence.

Main Results:

  • Perpetrators were predominantly female (91%).
  • 28% of perpetrators had psychiatric diagnoses, including factitious disorder imposed on self (10%), depression (9%), and personality disorders (7%).
  • Familial conflict/abuse (36%) and healthcare employment (17%) were notable factors. Induction was the most common falsification method (74%).
  • Common outcomes included separation (37%), no follow-up (22%), and victim death (12%). Recurrence exceeded 75%.

Conclusions:

  • Identifying common perpetrator traits in MSBP cases is crucial for clinical recognition.
  • The high recurrence rate underscores the persistent nature of this abuse dynamic.
  • Understanding these characteristics aids healthcare professionals in diagnosing and intervening in suspected cases.
Keywords:
Munchausen syndrome by proxyfactitious disorder imposed on anothermedical child abusepaediatric condition falsification

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