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MEDLIB-L  January 1996, Week 2

MEDLIB-L January 1996, Week 2

Subject:

MUNCHAUSEN SYNDROME

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Thu, 11 Jan 1996 10:01:00 GMT

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Patty,
 
There are a whole lot of refs in MEDLINE; enclosed are some
from 1990-95.
 
                                                  DOCUMENT: 1 of 36
 
UI: 94253633
AU: Baldwin MA
TI: Munchausen syndrome by proxy: neurological manifestations.
AD: Department of Pediatrics, Arizona Health Sciences Center, Tucson
    85724.
AB: Munchausen syndrome by proxy (MSP) is a recently described form of
    child abuse in which a caregiver fabricates or induces symptoms in a
    child in order to attract medical attention. The epidemiology,
    clinical features, diagnosis and the spectrum of MSP are reviewed.
    Central nervous system symptoms are a common presentation of MSP
    because they can be reported without confirmation. Three cases are
    reported to illustrate the most common neurological manifestations.
    It is important for neuroscience nurses to have an awareness that MSP
    can present as a neurologic problem, because appropriate management
    depends on early identification and treatment.
RF: 23
SO: J Neurosci Nurs 1994 Feb;26 (1):18-23
                                                  DOCUMENT: 2 of 36
 
UI: 94051498
AU: Mitchell I; Brummitt J ; DeForest J ; Fisher G
TI: Apnea and factitious illness (Munchausen syndrome) by proxy.
AD: Department of Paediatrics, University of Calgary, Alberta, Canada.
AB: OBJECTIVE. Munchausen syndrome by proxy (MSP) is recognized in the
    differential diagnosis of apparent life-threatening events, but the
    early signs and the full spectrum of this presentation are not well
    recognized. We aim to describe MSP presenting with apnea to
    illustrate this spectrum and the evolution in our management over a
    period of 10 years. PATIENTS AND RESULTS. Eleven children in five
    families seen in one institution and assessed by one team are
    described in detail. The children had apnea and/or pallor, but with a
    wider age range than usually seen with apparent life-threatening
    events, sometimes associated with other injuries, and a large
    percentage of parents were health care providers. In no case was
    apnea witnessed by health care professionals other than the parents.
    There were frequent disagreements in management between professionals
    and, consequently, delays in considering the diagnosis at first.
    There were two deaths. A team developed, allowing the diagnosis of
    MSP to be considered sooner and the cases to be assessed and managed
    consistently. CONCLUSION. MSP is part of child abuse, and it needs to
    be recognized by all physicians. Family assessment is required and
    the development of a team interested in MSP facilitates assessment
    and management.
 
SO: Pediatrics 1993 Dec;92 (6):810-4
                                                  DOCUMENT: 3 of 36
 
UI: 94238213
AU: Magnay AR; Debelle G ; Proops DW ; Booth IW
TI: Munchausen syndrome by proxy unmasked by nasal signs.
AD: Institute of Child Health, University of Birmingham, UK.
AB: The protean manifestations of child abuse continue to cause
    diagnostic difficulty. Recent observations of the high mortality in
    victims of Munchausen syndrome by proxy, and their siblings,
    reinforce the need for early diagnosis and appropriate intervention.
    We report the nasal manifestations which unmasked Munchausen syndrome
    by proxy in an infant who presented with intestinal and peri-orifical
    signs masquerading as Crohn's disease. The possibility of Munchausen
    syndrome by proxy should be considered in an infant with persistent
    nasal excoriation presenting as part of an undiagnosed illness.
 
SO: J Laryngol Otol 1994 Apr;108 (4):336-8
                                                  DOCUMENT: 4 of 36
 
UI: 93277144
AU: Meadow R
TI: False allegations of abuse and Munchausen syndrome by proxy [see
    comments]
AD: Department of Paediatrics and Child Health, St James's University
    Hospital, Leeds.
AB: Fourteen children from seven families are reported for whom false
    allegations of abuse were made by the mother. Twelve children were
    alleged to have incurred sexual abuse, one both sexual and physical
    abuse, and one physical abuse alone. Thirteen of the children had
    incurred, or were currently victims of, factitious illness abuse
    invented by the mother. The one child with no history of factitious
    illness abuse had a sibling who had incurred definite factitious
    illness abuse. The false allegations of abuse did not occur in the
    context of parental separation, divorce, or custody disputes
    concerning the children. They occurred in the context of Munchausen
    syndrome by proxy abuse. The age of the children, 3 to 9 years, was
    older than the usual age for Munchausen syndrome by proxy abuse. The
    mother was the source of the false allegations and was the person who
    encouraged or taught six of the children to substantiate allegations
    of sexual abuse.
CM: Comment in:Arch Dis Child1993 Nov;69(5):61
SO: Arch Dis Child 1993 Apr;68 (4):444-7
                                                  DOCUMENT: 5 of 36
 
UI: 93309764
AU: Macdonald HA
TI: Munchausen syndrome by proxy [letter]
 
SO: N Z Med J 1993 Jul 14;106 (959):292
                                                  DOCUMENT: 6 of 36
 
UI: 93086561
AU: Goss PW; McDougall PN
TI: Munchausen syndrome by proxy--a cause of preterm delivery.
AD: Department of Neonatology, Royal Children's Hospital, Parkville,
    Victoria.
AB: OBJECTIVE: To present the first case of Munchausen syndrome by proxy
    involving self-induced preterm delivery. CLINICAL FEATURES: A
    27-year-old Caucasian woman induced antepartum haemorrhage and
    rupture of membranes with a knitting needle at 26 weeks' gestation,
    leading to delivery of the infant. This "prenatal child abuse" led to
    a prolonged intensive care stay, extensive treatment and subsequent
    bronchopulmonary dysplasia. As the child recovered from the effects
    of extreme prematurity, he became a victim of fabricated illness and
    recurrent smothering episodes. INTERVENTION AND OUTCOME: After the
    diagnosis of Munchausen syndrome by proxy was made, the child was
    removed from the mother and he has since enjoyed good health.
    CONCLUSION: Self-induction of antepartum haemorrhage can lead to
    preterm delivery and may be recognisable by certain clinical
    parameters. The victim of self-induced preterm delivery, if survival
    ensues, may be subject to further abuse.
 
SO: Med J Aust 1992 Dec 7-21;157 (11-12):814-7
                                                  DOCUMENT: 7 of 36
 
UI: 93166315
AU: Mercer SO; Perdue JD
TI: Munchausen syndrome by proxy: social work's role.
AD: School of Social Work, University of Arkansas, Little Rock 72204.
AB: Munchausen syndrome by proxy is the diagnosis used to describe a
    variation of child abuse whereby the parent or adult caregiver
    fabricates a medical history or induces symptoms in the child, or
    both, resulting in unnecessary examinations, treatments,
    hospitalizations, and even death. This article reviews the assessment
    procedures, provides case studies, and describes family dynamics of
    the syndrome. The authors make recommendations for team management of
    the child-family system and recommendations for social workers. They
    propose broadening the assessment of the family on the basis of
    knowledge of the widespread physical and economic oppression of women
    and children in our society.
RF: 19
SO: Soc Work 1993 Jan;38 (1):74-81
                                                  DOCUMENT: 8 of 36
 
UI: 93191309
AU: Mehta P; Bussing R
TI: Factitious coagulopathy due to Munchausen syndrome by proxy
    [editorial]
 
SO: Am J Pediatr Hematol Oncol 1993 Feb;15 (1):124-5
                                                  DOCUMENT: 9 of 36
 
UI: 93191310
AU: Babcock J; Hartman K ; Pedersen A ; Murphy M ; Alving B
TI: Rodenticide-induced coagulopathy in a young child. A case of
    Munchausen syndrome by proxy.
AD: Department of Pediatrics, Walter Reed Army Medical Center, Washington,
    D.C. 20307-5100.
AB: PURPOSE: To present the diagnosis and management of superwarfarin
    ingestion, a cause of serious and prolonged coagulopathy. METHODS:
    Specific identification of the anticoagulant was made by
    high-pressure liquid chromatography. RESULTS: A 24 month-old child
    developed bruises and a prolonged prothrombin time (PT) and activated
    partial thromboplastin time (aPTT) after receiving multiple doses of
    brodifacoum, a superwarfarin rodenticide. The coagulopathy was
    treated successfully with large doses of parenteral and oral vitamin
    K1; fresh frozen plasma was administered as a precautionary measure
    on two occasions. After the first 10 days of the child's
    hospitalization, the mother was identified as the source of
    brodifacoum, exemplifying the behavior described as Munchausen
    syndrome by proxy. Oral vitamin K1 was initiated and continued in an
    outpatient setting with tapering doses over nine months, using the PT
    as a guide for therapy. CONCLUSIONS: This report emphasizes the
    necessity of recognizing rodenticide poisoning and investigating its
    source. Frequent monitoring of the PT is essential to prevent
    hemorrhagic complications due to repeat exposure, inadequate vitamin
    K1 therapy, or noncompliance.
 
SO: Am J Pediatr Hematol Oncol 1993 Feb;15 (1):126-30
                                                  DOCUMENT: 10 of 36
 
UI: 92152965
AU: Bools CN; Neale BA ; Meadow SR
TI: Co-morbidity associated with fabricated illness (Munchausen syndrome
    by proxy).
AD: Department of Paediatrics and Child Health, St James's University
    Hospital, Leeds.
AB: Fifty six children who had been victims of fabricated illnesses and
    82 of their 103 siblings were studied. In addition to the index
    fabrication, 64% of index children had had other illnesses fabricated
    by their mothers. Twenty nine per cent of the index children had a
    history of failure to thrive and 29% a history of non-accidental
    injury, inappropriate medication, or neglect. Seventy three per cent
    of the index children had been affected by at least one of these
    additional problems. Eleven per cent of the siblings had died in
    early childhood, the cause of death not being identified. Thirty nine
    per cent of siblings themselves had had illnesses fabricated by their
    mothers, and 17% had been affected by either failure to thrive,
    non-accidental injury, inappropriate medication, or neglect.
 
SO: Arch Dis Child 1992 Jan;67 (1):77-9
                                                  DOCUMENT: 11 of 36
 
UI: 92327171
AU: Crouse KA
TI: Munchausen syndrome by proxy: recognizing the victim.
AB: Munchausen syndrome by proxy is a serious and potentially lethal form
    of child abuse in which a parent deliberately induces or reports
    physical symptoms in a child. The child not only suffers from
    parent's action, but he or she is subjected to an extensive battery
    of invasive medical and radiological testing that are unnecessary and
    painful. All health care professionals must work together to ensure
    that the syndrome is discovered in time and the child is protected.
    The child's psychological and physiological welfare are in danger.
 
SO: Pediatr Nurs 1992 May-Jun;18 (3):249-52
                                                  DOCUMENT: 12 of 36
 
UI: 95114842
AU: Hochhauser KG; Richardson RA
TI: Munchausen syndrome by proxy: an exploratory study of pediatric
    nurses' knowledge and involvement.
AD: School of Family and Consumer Studies, Kent State University, OH.
AB: The awareness and involvement of pediatric nurses in the type of
    child abuse known as Munchausen syndrome by proxy (MSBP) was explored
    in this study. A questionnaire assessing knowledge about and extent
    of involvement in the identification of MSBP cases and demographic
    information was completed by 320 registered nurses (RNS) employed at
    a children's hospital. Fewer than half of the subjects (47%)
    responded that they had heard of MSBP. Those who had heard of MSBP
    demonstrated only a moderate level of knowledge of the signs and
    signals of the syndrome. Thirty-four percent of those nurses who had
    heard of MSBP had been involved in the detection of cases. Findings
    suggest that it might be important for pediatric hospitals to include
    information about MSBP in their own required classes or in-house
    seminars.
 
SO: J Pediatr Nurs 1994 Oct;9 (5):313-20
                                                  DOCUMENT: 13 of 36
 
UI: 95094030
AU: Bools C; Neale B ; Meadow R
TI: Munchausen syndrome by proxy: a study of psychopathology [see
    comments]
AD: Department of Pediatrics and Child Health, St. James's University
    Hospital, Leeds, UK.
AB: Munchausen Syndrome by Proxy (the fabrication of illness by a mother
    in her child) is often a serious form of child abuse that has been
    recognized increasingly over recent years. Approximately one-half of
    the mothers in this study had either smothered or poisoned their
    child as part of their fabrications. Lifetime psychiatric histories
    are reported for 47 of the mothers. Thirty-four had a history of a
    Factitious or Somatoform disorder, 26 a history of self harm, and 10
    of alcohol or drug misuse. Nine mothers had a forensic history
    independent of convictions related to child abuse. Nineteen of these
    mothers were interviewed from 1-15 years after the original
    fabrications. The most notable psychopathology was the presence of a
    personality disorder in 17 of the mothers, which were predominantly
    Histrionic and Borderline types. Most subjects, however, met the
    criteria for more than one category of personality disorder.
CM: Comment in:Child Abuse Negl1994 Sep;18(9):769-7
SO: Child Abuse Negl 1994 Sep;18 (9):773-88
                                                  DOCUMENT: 14 of 36
 
UI: 95094031
AU: Porter GE; Heitsch GM ; Miller MD
TI: Munchausen syndrome by proxy: unusual manifestations and disturbing
    sequelae [see comments]
AD: Department of Pediatrics, Marshfield Clinic, Marshfield Medical
    Research Foundation, WI 54449.
AB: Since the initial description of Munchausen Syndrome by Proxy (MSBP)
    (Meadow, 1977) , numerous cases have been reported varying from as
    simple as the complaint of a nonexistent symptom to those as
    complicated as altered laboratory tests leading to the false
    diagnosis of cystic fibrosis (Orenstein & Wasserman, 1986; Rosenberg,
    1987) . We report three findings previously unreported: esophageal
    perforation, retrograde intussusception, and tooth loss. Bradycardia
    has been previously reported associated with suffocation (Meadow,
    1984) , but in our case may have been caused by carotid artery
    massage. We also suggest possible induction by the mother of
    premature rupture of fetal membrane leading to delivery of infected
    infants.
CM: Comment in:Child Abuse Negl1994 Sep;18(9):769-71
SO: Child Abuse Negl 1994 Sep;18 (9):789-94
                                                  DOCUMENT: 15 of 36
 
UI: 95271457
AU: Klebes C; Fay S
TI: Munchausen syndrome by proxy: a review, case study, and nursing
    implications.
AD: School of Nursing, Indiana University, Indianapolis, USA.
AB: Munchausen syndrome by proxy (MSBP) is a serious form of child abuse
    that often remains undetected for years. Victims (and often their
    siblings) suffer serious physiological and psychological damage and
    sometimes even death. Nurses educated about this syndrome can have
    significant impact on its earlier diagnosis and intervention. This
    article presents a literature review and case study and concludes
    with a discussion of nursing implications including the effect of
    MSBP on nursing staff.
RF: 14
SO: J Pediatr Nurs 1995 Apr;10 (2):93-8
                                                  DOCUMENT: 16 of 36
 
UI: 95049089
AU: Feldman MD
TI: Denial in Munchausen syndrome by proxy: the consulting psychiatrist's
    dilemma.
AD: University of Alabama Medical Center, Birmingham.
AB: OBJECTIVE: The purpose of this review, which also includes the report
    of a new case, is to discuss the pervasive denial of responsibility
    among individuals who have engaged in Munchausen syndrome by proxy
    (MSBP) behavior. In MSBP, a caretaker (almost always the mother)
    fabricates or induces illness in her child; she then presents the
    child for medical treatment, disclaiming knowledge of the etiology of
    the illness. METHOD: Literature searches of several computer
    databases were performed, and ninety-two citations dealing with MSBP,
    culled from medical, legal, and lay publications, were examined for
    descriptions of caretakers' responses to being confronted with the
    allegation of MSBP. Thirty-four citations contained relevant material,
    which was combined with observations from cases in which the author
    has served as a consultant. RESULTS: Caretakers engaging in MSBP
    consistently deny any role in the dissimulation, even when confronted
    with compelling evidence. This denial complicates management, though
    intervention must focus on ensuring the safety of the child
    regardless of the caregiver's response. CONCLUSIONS: Techniques
    sometimes advocated in factitious disorders in general may be useful
    in stopping the abusive behavior; however, no consistently effective
    strategy for overcoming denial in MSBP has yet been described.
 
SO: Int J Psychiatry Med 1994;24 (2):121-8
                                                  DOCUMENT: 17 of 36
 
UI: 95235081
AU: Barker LH; Howell RJ
TI: Munchausen syndrome by proxy in false allegations of child sexual
    abuse: legal implications.
AD: Brigham Young University, Provo, UT 84602, USA.
AB: A review of the literature regarding Munchausen syndrome by proxy in
    relation to allegations of child sexual abuse is presented. Problems
    in the diagnosis of Munchausen syndrome by proxy in these cases can
    be the result of a failure to consider that the allegations may be
    false, legal issues surrounding the child's testimony, and other
    biases in professional and legal attitudes towards allegations of
    sexual abuse. A proposal for a more stringent standard of care is
    made. Treatment of Munchausen syndrome by proxy is best effected by
    case management, with the person who made the diagnosis managing the
    case throughout the treatment. This person should act as liaison to
    relay information between all the parties involved.
RF: 36
SO: Bull Am Acad Psychiatry Law 1994;22 (4):499-510
                                                  DOCUMENT: 18 of 36
 
UI: 95191720
AU: Krupinski M; Tutsch-Bauer E ; Frank R ; Brodherr-Heberlein S ; Soyka M
TI: [Munchausen syndrome by proxy]
AD: Psychiatrische Klinik und Poliklinik, Universit at M unchen.
AB: The term "Munchausen by proxy" denotes a special form of factitious
    disorder and a rare kind of child abuse. We present the case of a
    12-year-old boy, whose mother's manipulations culminated in his
    immobilization in a wheelchair and the implantation of a pacemaker.
    Problems of diagnosis and clinical management of Munchausen by proxy
    are discussed.
 
SO: Nervenarzt 1995 Jan;66 (1):36-40
                                                  DOCUMENT: 19 of 36
 
UI: 95199165
AU: Hertz S; Skau K ; Uldall P
TI: [Munchausen syndrome by proxy]
AD: Barne- og Ungdomspsykiatrisk afd M, Hiller d Sygehus.
AB: Munchausen Syndrome by Proxy (MSbP) in children is a form of child
    abuse in which a parent (usually the mother) or other care-taker
    feigns or fabricates disease symptoms in the child, often to the
    extent of causing serious physical harm, sometimes even resulting in
    death. Even if the child does not suffer actual physical harm, there
    is great danger that his or her social and mental development may be
    jeopardized. Health care personnel risk becoming party to the abuse
    through exposing the child to unnecessary medical procedures. A case
    of MSbP involving two siblings is presented in the article, together
    with a brief summary of current knowledge of the syndrome and
    measures for its management, emphasising the necessity of close
    cooperation between paediatrician, child psychiatrist and the social
    services.
 
SO: Nord Med 1995;110 (3):102-4
                                                  DOCUMENT: 20 of 36
 
UI: 90205078
AU: Kahan BB; Yorker BC
TI: Munchausen syndrome by proxy.
AD: Medical/ Psychiatric Unit, Henrietta Egleston Hospital for Children,
    Atlanta, GA.
 
SO: J Sch Health 1990 Mar;60 (3):108-10
                                                  DOCUMENT: 21 of 36
 
UI: 91016694
AU: Alexander R; Smith W ; Stevenson R
TI: Serial Munchausen syndrome by proxy.
AD: Department of Pediatrics, University of Iowa Hospitals and Clinics,
    Iowa City.
AB: Five cases of Munchausen syndrome by proxy (MSBP) are presented in
    which more than one child in the family was victimized. There was a
    high incidence of maternal psychiatric histories, marital
    difficulties, and M unchhausen syndrome in the mothers themselves.
    Seventy-one percent of the children in the families were known to be
    victims of MSBP; four of these children (31%) died. Multiple-child
    MSBP may reflect more significant maternal psychopathology than found
    in other cases of MSBP, or it may indicate the deteriorating
    consequences to the mother and other children in the family if this
    syndrome is not identified with the first child and effective
    interventions made.
 
SO: Pediatrics 1990 Oct;86 (4):581-5
                                                  DOCUMENT: 22 of 36
 
UI: 91045383
AU: Ksia zyk J; Socha J ; Rujner J ; Ry zko J
TI: ["Munchausen syndrome by proxyo as an example of diagnostic error]
AD: Oddzialu Gastroenterologicznego Centrum Zdrowia Dziecka w Warszawie.
AB: A case of the girl who underwent multiple hospitalizations is
    presented. Gastrointestinal disorders were seen in the infancy
    together with skin rash of allergic type, hypoglycaemia without any
    clear reason in the fourth year of age, and polyuria with
    hyponatremia and hypokalemia since the sixth year of age. Mother's
    lack of concern was unexplainable in view of the deteriorating
    child's health. Samples of the urine and faeces supplied by the
    mother have shown the laboratory findings suggesting that potassium
    chloride was added to the faeces and natrium hydrocarbonate--to the
    urine. Urine collected during polyuria contained large quantities of
    furosemide. Long-term follow-up, numerous examinations and performed
    tests have led to the diagnosis of the particular form of the
    ill-treated child syndrome, so-called "Munchausenn by proxyo
    syndrome.
 
SO: Pol Tyg Lek 1990 Mar 10-26;45 (12-13):255-6
                                                  DOCUMENT: 23 of 36
 
UI: 91070877
AU: Kravitz RM; Wilmott RW
TI: Munchausen syndrome by proxy presenting as factitious apnea.
AD: Division of Pulmonary Medicine, Children's Hospital Medical Center,
    Cincinnati, OH 45229-2899.
 
SO: Clin Pediatr (Phila) 1990 Oct;29 (10):587-92
                                                  DOCUMENT: 24 of 36
 
UI: 91079246
AU: Stevenson RD; Alexander R
TI: Munchausen syndrome by proxy presenting as a developmental
    disability.
AD: Department of Pediatrics, University of Virginia, Charlottesville.
AB: Munchausen syndrome by proxy (MSBP) is a form of child abuse in which
    a parent falsifies illness in a child by fabricating or producing
    symptoms and presenting the child for medical care while disclaiming
    knowledge as to the cause of the problem. This report presents the
    case history of a child diagnosed with MSBP who was portrayed as
    having multiple developmental disabilities by her mother. Three
    elements of the case are noteworthy. The emphasis by the mother on
    multiple developmental disabilities has not been reported. The
    complexity of this case is unusual and may reflect the complexity of
    the mother's psychopathology. The interdisciplinary team evaluation
    was instrumental in making the diagnosis.
 
SO: J Dev Behav Pediatr 1990 Oct;11 (5):262-4
                                                  DOCUMENT: 25 of 36
 
UI: 92027876
AU: Godding V; Kruth M
TI: Compliance with treatment in asthma and Munchausen syndrome by proxy.
AD: UCL University Hospital of Mont-Godinne, Yvoir, Belgium.
AB: Among 1648 asthmatic patients, 17 families (1%) were identified as
    having Munchausen syndrome by proxy. Ten families did not treat their
    children's, attacks or refused medical care, and seven exaggerated
    the severity of symptoms to obtain invasive investigations and
    treatment. All the families had disturbed psychosocial backgrounds.
    The abuse consisted mainly of neglect, in that necessary treatment
    was not given. In some cases a more direct form of abuse was observed,
    when useless and sometimes harmful investigations and treatment were
    given. We conclude that medical control of the compliance of both
    parents and children is necessary in the management of childhood
    asthma.
 
SO: Arch Dis Child 1991 Aug;66 (8):956-60
                                                  DOCUMENT: 26 of 36
 
UI: 91092880
AU: Roth D
TI: How "mildo is mild Munchausen syndrome by proxy?
AD: Department of Psychiatry, Hadassah University Hospital, Jerusalem,
    Israel.
AB: This paper describes four cases of Munchausen Syndrome by Proxy (MSbP)
    ,in each of whom the disorder could be considered mild from the
    physical viewpoint. However, in all cases a severe emotional
    disturbance was evident in the mother-child relationship, and certain
    significant features were common to each case, including the dynamics
    of the development of the disorder. In all, maternal anxiety resulted
    in the mother perceiving the child as sick, leading to her insistence
    that he/she receive medical attention. A follow-up over several years
    showed severe disturbances in the emotional development of all the
    children. It is thus suggested that mild cases of MSbP may be
    indicators of severely disturbed mother-child relationships, raising
    important questions about their proper management.
 
SO: Isr J Psychiatry Relat Sci 1990;27 (3):160-7
                                                  DOCUMENT: 27 of 36
 
UI: 91145794
AU: Mehl AL; Coble L ; Johnson S
TI: Munchausen syndrome by proxy: a family affair.
AD: Colorado Permanente Medical Group, Boulder.
AB: Munchausen syndrome by proxy is an unusual form of child abuse: a
    child presents with an illness that has been factitiously produced by
    a parent, typically the mother. A case of chronic illicit insulin
    administration to a one-year-old girl is described. Despite temporary
    separation of the child from the mother and long-term psychiatric
    intervention, factitious illnesses continued, including urine
    specimen contamination, laxative-induced diarrhea, suspected bladder
    catheterization, and suspected poisoning. Retrospective review of the
    medical records of the mother and two siblings demonstrated
    previously unrecognized evidence of factitious illnesses. The medical
    records contained evidence of 30 separate episodes of suspected or
    documented factitious illness in these four members of the same
    family. This unique family illustrates the significant morbidity of
    Munchausen syndrome by proxy and a poor response to psychiatric
    treatment.
 
SO: Child Abuse Negl 1990;14 (4):577-85
                                                  DOCUMENT: 28 of 36
 
UI: 90254448
 
TI: Munchausen syndrome by proxy [letter; comment]
CM: Comment on:Child Abuse Negl1987;11(4):547-63
SO: Child Abuse Negl 1990;14 (2):289-90
                                                  DOCUMENT: 29 of 36
 
UI: 92129238
AU: Turk LJ; Hanrahan KM ; Weber ER
TI: Munchausen Syndrome by Proxy: a nursing overview.
AB: Munchausen Syndrome by Proxy is a common but often undetected form of
    child abuse in which a parent fabricates or falsifies an illness in
    the child and then presents the child for medical treatment,
    disclaiming knowledge as to the etiology of the illness. Nurses are
    instrumental in the early identification and detection of Munchausen
    Syndrome by Proxy. A case study emphasizes the role of nurses as part
    of the multidisciplinary approach. Use of the nursing process
    demonstrates comprehensive care in management.
RF: 14
SO: Issues Compr Pediatr Nurs 1990 Oct-Dec;13 (4):279-88
                                                  DOCUMENT: 30 of 36
 
UI: 91127443
AU: Yomtovian R; Swanger R
TI: Munchausen syndrome by proxy documented by discrepant blood typing.
AD: Institute of Pathology, Case Western Reserve University School of
    Medicine, Cleveland, Ohio.
AB: The authors describe a case of Munchausen syndrome by proxy, a form
    of child abuse, documented by use of routine blood bank serologic
    procedures. While immunohematologic testing has been used in the
    legal arena to resolve issues of disputed paternity and to
    investigate instances of criminal acts, the authors believe this to
    be the first documented application to this clinical disorder.
 
SO: Am J Clin Pathol 1991 Feb;95 (2):232-3
                                                  DOCUMENT: 31 of 36
 
UI: 91176677
AU: Sullivan CA; Francis GL ; Bain MW ; Hartz J
TI: Munchausen syndrome by proxy: 1990. A portent for problems?
AD: Department of Pediatrics, Walter Reed Army Medical Center, Washington,
    D.C. 20307-5001.
 
SO: Clin Pediatr (Phila) 1991 Feb;30 (2):112-6
                                                  DOCUMENT: 32 of 36
 
UI: 91224394
AU: Meadow R
TI: Neurological and developmental variants of Munchausen syndrome by
    proxy.
AD: Department of Paediatrics and Child Health, St. James's University
    Hospital, Leeds.
 
SO: Dev Med Child Neurol 1991 Mar;33 (3):270-2
                                                  DOCUMENT: 33 of 36
 
UI: 91273796
AU: Loredo-Abdal a A; Sierra-G. de Quevedo JJ ; Oldak-Skvirsky D ;
    Carbajal-Rodr iguez L
TI: [Munchausen syndrome in children: report of 2 cases]
AD: Departamento de Medicina Interna, Instituto Nacional de Pediatr ia,
    Mexico, D.F.
AB: We report the existence of two cases of an infrequently know form of
    child abuse, Munchausen syndrome "by proxyo treated in the Department
    of Internal Medicine of the National Institute of Pediatrics. We have
    considered it necessary to emphasize the way this clinical entity is
    presented, pointing out the exact clinical data and how the relatives
    referred to them when faced with the treating physician, the number
    of people involved in treating the children as well as the exagerated
    number of laboratory and X-ray studies performed. The discrepancy in
    terminology to point to this disease, allows for the use of the term
    "Munchausen syndrome in childreno to differentiate it from that used
    in psychiatry. The need to alert the medical community who treats
    these children on this rarely seen disease, will allow for its
    recognition and early treatment which avoid a reinforcement of the
    perpetrators attitudes.
 
SO: Bol Med Hosp Infant Mex 1991 Feb;48 (2):121-5
                                                  DOCUMENT: 34 of 36
 
UI: 92065658
AU: Kahn G; Goldman E
TI: Munchausen syndrome by proxy: mother fabricates infant's hearing
    impairment.
AD: Dept. of Pediatrics, University of Iowa, Iowa City 52242.
AB: Munchausen syndrome by proxy is a form of child abuse in which a
    mother causes or simulates her child's symptoms and presents the
    child for diagnosis and treatment. All previously reported cases have
    involved acute illnesses. This case study describes the ways in which
    a mother obtained a diagnosis of sensorineural hearing loss as well
    as amplification for her normally hearing infant.
 
SO: J Speech Hear Res 1991 Aug;34 (4):957-9
                                                  DOCUMENT: 35 of 36
 
UI: 92074045
AU: Sofinowski RE; Butler PM
TI: Munchausen syndrome by proxy: a review.
AD: Department of Psychiatry, Baylor College of Medicine, Houston, TX
    77030.
AB: Munchausen syndrome by proxy is a form of child abuse in which a
    parent or caretaker simulates or produces illness in a child. Case
    reports of Munchausen syndrome by proxy document a wide and confusing
    spectrum of symptoms. The children who are the victims of this
    syndrome suffer morbidity linked to numerous unnecessary hospital
    admissions and diagnostic procedures, severe psychological morbidity,
    and a significant risk of mortality. Because of these extreme
    consequences, all health-care professionals must be able to recognize
    its warning signals.
RF: 38
SO: Tex Med 1991 Oct;87 (10):66-9
                                                  DOCUMENT: 36 of 36
 
UI: 92149053
AU: Lim LC; Yap HK ; Lim JW
TI: Munchausen syndrome by proxy.
AD: Department of Pyschological Medicine, National University Hospital,
    Singapore.
AB: Munchausen syndrome by proxy is the falsification of symptoms by
    parents which results in their children having unnecessary and
    sometimes harmful hospital procedures. We describe a case of
    Munchausen syndrome by proxy in a 15 month-old toddler. The diagnosis,
    management and outcome of this syndrome is also discussed.
 
SO: J Singapore Paediatr Soc 1991;33 (1-2):59-62
 
 
Naina Pandita
Indian MEDLARS Centre,
New Delhi, India

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January 2004, Week 3
January 2004, Week 2
January 2004, Week 1
December 2003, Week 5
December 2003, Week 4
December 2003, Week 3
December 2003, Week 2
December 2003, Week 1
November 2003, Week 5
November 2003, Week 4
November 2003, Week 3
November 2003, Week 2
November 2003, Week 1
October 2003, Week 5
October 2003, Week 4
October 2003, Week 3
October 2003, Week 2
October 2003, Week 1
September 2003, Week 5
September 2003, Week 4
September 2003, Week 3
September 2003, Week 2
September 2003, Week 1
August 2003, Week 5
August 2003, Week 4
August 2003, Week 3
August 2003, Week 2
August 2003, Week 1
July 2003, Week 5
July 2003, Week 4
July 2003, Week 3
July 2003, Week 2
July 2003, Week 1
June 2003, Week 5
June 2003, Week 4
June 2003, Week 3
June 2003, Week 2
June 2003, Week 1
May 2003, Week 5
May 2003, Week 4
May 2003, Week 3
May 2003, Week 2
May 2003, Week 1
April 2003, Week 5
April 2003, Week 4
April 2003, Week 3
April 2003, Week 2
April 2003, Week 1
March 2003, Week 5
March 2003, Week 4
March 2003, Week 3
March 2003, Week 2
March 2003, Week 1
February 2003, Week 4
February 2003, Week 3
February 2003, Week 2
February 2003, Week 1
January 2003, Week 5
January 2003, Week 4
January 2003, Week 3
January 2003, Week 2
January 2003, Week 1
December 2002, Week 5
December 2002, Week 4
December 2002, Week 3
December 2002, Week 2
December 2002, Week 1
November 2002, Week 5
November 2002, Week 4
November 2002, Week 3
November 2002, Week 2
November 2002, Week 1
October 2002, Week 5
October 2002, Week 4
October 2002, Week 3
October 2002, Week 2
October 2002, Week 1
September 2002, Week 5
September 2002, Week 4
September 2002, Week 3
September 2002, Week 2
September 2002, Week 1
August 2002, Week 5
August 2002, Week 4
August 2002, Week 3
August 2002, Week 2
August 2002, Week 1
July 2002, Week 5
July 2002, Week 4
July 2002, Week 3
July 2002, Week 2
July 2002, Week 1
June 2002, Week 5
June 2002, Week 4
June 2002, Week 3
June 2002, Week 2
June 2002, Week 1
May 2002, Week 5
May 2002, Week 4
May 2002, Week 3
May 2002, Week 2
May 2002, Week 1
April 2002, Week 5
April 2002, Week 4
April 2002, Week 3
April 2002, Week 2
April 2002, Week 1
March 2002, Week 5
March 2002, Week 4
March 2002, Week 3
March 2002, Week 2
March 2002, Week 1
February 2002, Week 4
February 2002, Week 3
February 2002, Week 2
February 2002, Week 1
January 2002, Week 5
January 2002, Week 4
January 2002, Week 3
January 2002, Week 2
January 2002, Week 1
December 2001, Week 5
December 2001, Week 4
December 2001, Week 3
December 2001, Week 2
December 2001, Week 1
November 2001, Week 5
November 2001, Week 4
November 2001, Week 3
November 2001, Week 2
November 2001, Week 1
October 2001, Week 5
October 2001, Week 4
October 2001, Week 3
October 2001, Week 2
October 2001, Week 1
September 2001, Week 5
September 2001, Week 4
September 2001, Week 3
September 2001, Week 2
September 2001, Week 1
August 2001, Week 5
August 2001, Week 4
August 2001, Week 3
August 2001, Week 2
August 2001, Week 1
July 2001, Week 5
July 2001, Week 4
July 2001, Week 3
July 2001, Week 2
July 2001, Week 1
June 2001, Week 5
June 2001, Week 4
June 2001, Week 3
June 2001, Week 2
June 2001, Week 1
May 2001, Week 5
May 2001, Week 4
May 2001, Week 3
May 2001, Week 2
May 2001, Week 1
April 2001, Week 5
April 2001, Week 4
April 2001, Week 3
April 2001, Week 2
April 2001, Week 1
March 2001, Week 5
March 2001, Week 4
March 2001, Week 3
March 2001, Week 2
March 2001, Week 1
February 2001, Week 4
February 2001, Week 3
February 2001, Week 2
February 2001, Week 1
January 2001, Week 5
January 2001, Week 4
January 2001, Week 3
January 2001, Week 2
January 2001, Week 1
December 2000, Week 5
December 2000, Week 4
December 2000, Week 3
December 2000, Week 2
December 2000, Week 1
November 2000, Week 5
November 2000, Week 4
November 2000, Week 3
November 2000, Week 2
November 2000, Week 1
October 2000, Week 5
October 2000, Week 4
October 2000, Week 3
October 2000, Week 2
October 2000, Week 1
September 2000, Week 5
September 2000, Week 4
September 2000, Week 3
September 2000, Week 2
September 2000, Week 1
August 2000, Week 5
August 2000, Week 4
August 2000, Week 3
August 2000, Week 2
August 2000, Week 1
July 2000, Week 5
July 2000, Week 4
July 2000, Week 3
July 2000, Week 2
July 2000, Week 1
June 2000, Week 5
June 2000, Week 4
June 2000, Week 3
June 2000, Week 2
June 2000, Week 1
May 2000, Week 5
May 2000, Week 4
May 2000, Week 3
May 2000, Week 2
May 2000, Week 1
April 2000, Week 5
April 2000, Week 4
April 2000, Week 3
April 2000, Week 2
April 2000, Week 1
March 2000, Week 5
March 2000, Week 4
March 2000, Week 3
March 2000, Week 2
March 2000, Week 1
February 2000, Week 5
February 2000, Week 4
February 2000, Week 3
February 2000, Week 2
February 2000, Week 1
January 2000, Week 5
January 2000, Week 4
January 2000, Week 3
January 2000, Week 2
January 2000, Week 1
December 1999, Week 5
December 1999, Week 4
December 1999, Week 3
December 1999, Week 2
December 1999, Week 1
November 1999, Week 5
November 1999, Week 4
November 1999, Week 3
November 1999, Week 2
November 1999, Week 1
October 1999, Week 5
October 1999, Week 4
October 1999, Week 3
October 1999, Week 2
October 1999, Week 1
September 1999, Week 5
September 1999, Week 4
September 1999, Week 3
September 1999, Week 2
September 1999, Week 1
August 1999, Week 5
August 1999, Week 4
August 1999, Week 3
August 1999, Week 2
August 1999, Week 1
July 1999, Week 5
July 1999, Week 4
July 1999, Week 3
July 1999, Week 2
July 1999, Week 1
June 1999, Week 5
June 1999, Week 4
June 1999, Week 3
June 1999, Week 2
June 1999, Week 1
May 1999, Week 5
May 1999, Week 4
May 1999, Week 3
May 1999, Week 2
May 1999, Week 1
April 1999, Week 5
April 1999, Week 4
April 1999, Week 3
April 1999, Week 2
April 1999, Week 1
March 1999, Week 5
March 1999, Week 4
March 1999, Week 3
March 1999, Week 2
March 1999, Week 1
February 1999, Week 4
February 1999, Week 3
February 1999, Week 2
February 1999, Week 1
January 1999, Week 5
January 1999, Week 4
January 1999, Week 3
January 1999, Week 2
January 1999, Week 1
December 1998, Week 5
December 1998, Week 4
December 1998, Week 3
December 1998, Week 2
December 1998, Week 1
November 1998, Week 5
November 1998, Week 4
November 1998, Week 3
November 1998, Week 2
November 1998, Week 1
October 1998, Week 5
October 1998, Week 4
October 1998, Week 3
October 1998, Week 2
October 1998, Week 1
September 1998, Week 5
September 1998, Week 4
September 1998, Week 3
September 1998, Week 2
September 1998, Week 1
August 1998, Week 5
August 1998, Week 4
August 1998, Week 3
August 1998, Week 2
August 1998, Week 1
July 1998, Week 5
July 1998, Week 4
July 1998, Week 3
July 1998, Week 2
July 1998, Week 1
June 1998, Week 5
June 1998, Week 4
June 1998, Week 3
June 1998, Week 2
June 1998, Week 1
May 1998, Week 5
May 1998, Week 4
May 1998, Week 3
May 1998, Week 2
May 1998, Week 1
April 1998, Week 5
April 1998, Week 4
April 1998, Week 3
April 1998, Week 2
April 1998, Week 1
March 1998, Week 5
March 1998, Week 4
March 1998, Week 3
March 1998, Week 2
March 1998, Week 1
February 1998, Week 4
February 1998, Week 3
February 1998, Week 2
February 1998, Week 1
January 1998, Week 5
January 1998, Week 4
January 1998, Week 3
January 1998, Week 2
January 1998, Week 1
December 1997, Week 5
December 1997, Week 4
December 1997, Week 3
December 1997, Week 2
December 1997, Week 1
November 1997, Week 5
November 1997, Week 4
November 1997, Week 3
November 1997, Week 2
November 1997, Week 1
October 1997, Week 5
October 1997, Week 4
October 1997, Week 3
October 1997, Week 2
October 1997, Week 1
September 1997, Week 5
September 1997, Week 4
September 1997, Week 3
September 1997, Week 2
September 1997, Week 1
August 1997, Week 5
August 1997, Week 4
August 1997, Week 3
August 1997, Week 2
August 1997, Week 1
July 1997, Week 5
July 1997, Week 4
July 1997, Week 3
July 1997, Week 2
July 1997, Week 1
June 1997, Week 5
June 1997, Week 4
June 1997, Week 3
June 1997, Week 2
June 1997, Week 1
May 1997, Week 5
May 1997, Week 4
May 1997, Week 3
May 1997, Week 2
May 1997, Week 1
April 1997, Week 5
April 1997, Week 4
April 1997, Week 3
April 1997, Week 2
April 1997, Week 1
March 1997, Week 5
March 1997, Week 4
March 1997, Week 3
March 1997, Week 2
March 1997, Week 1
February 1997, Week 4
February 1997, Week 3
February 1997, Week 2
February 1997, Week 1
January 1997, Week 5
January 1997, Week 4
January 1997, Week 3
January 1997, Week 2
January 1997, Week 1
December 1996, Week 5
December 1996, Week 4
December 1996, Week 3
December 1996, Week 2
December 1996, Week 1
November 1996, Week 5
November 1996, Week 4
November 1996, Week 3
November 1996, Week 2
November 1996, Week 1
October 1996, Week 5
October 1996, Week 4
October 1996, Week 3
October 1996, Week 2
October 1996, Week 1
September 1996, Week 5
September 1996, Week 4
September 1996, Week 3
September 1996, Week 2
September 1996, Week 1
August 1996, Week 5
August 1996, Week 4
August 1996, Week 3
August 1996, Week 2
August 1996, Week 1
July 1996, Week 5
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July 1996, Week 3
July 1996, Week 2
July 1996, Week 1
June 1996, Week 5
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June 1996, Week 3
June 1996, Week 2
June 1996, Week 1
May 1996, Week 5
May 1996, Week 4
May 1996, Week 3
May 1996, Week 2
May 1996, Week 1
April 1996, Week 5
April 1996, Week 4
April 1996, Week 3
April 1996, Week 2
April 1996, Week 1
March 1996, Week 5
March 1996, Week 4
March 1996, Week 3
March 1996, Week 2
March 1996, Week 1
February 1996, Week 5
February 1996, Week 4
February 1996, Week 3
February 1996, Week 2
February 1996, Week 1
January 1996, Week 5
January 1996, Week 4
January 1996, Week 3
January 1996, Week 2
January 1996, Week 1
December 1995, Week 5
December 1995, Week 4
December 1995, Week 3
December 1995, Week 2
December 1995, Week 1
November 1995, Week 5
November 1995, Week 4
November 1995, Week 3
November 1995, Week 2
November 1995, Week 1
October 1995, Week 5
October 1995, Week 4
October 1995, Week 3
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October 1995, Week 1
September 1995, Week 5
September 1995, Week 4
September 1995, Week 3
September 1995, Week 2
September 1995, Week 1
August 1995, Week 5
August 1995, Week 4
August 1995, Week 3
August 1995, Week 2
August 1995, Week 1
July 1995, Week 5
July 1995, Week 4
July 1995, Week 3
July 1995, Week 2
July 1995, Week 1
June 1995, Week 5
June 1995, Week 4
June 1995, Week 3
June 1995, Week 2
June 1995, Week 1
May 1995, Week 5
May 1995, Week 4
May 1995, Week 3
May 1995, Week 2
May 1995, Week 1
April 1995, Week 5
April 1995, Week 4
April 1995, Week 3
April 1995, Week 2
April 1995, Week 1
March 1995, Week 5
March 1995, Week 4
March 1995, Week 3
March 1995, Week 2
March 1995, Week 1
February 1995, Week 5
February 1995, Week 4
February 1995, Week 3
February 1995, Week 2
February 1995, Week 1
January 1995, Week 5
January 1995, Week 4
January 1995, Week 3
January 1995, Week 2
January 1995, Week 1
December 1994, Week 5
December 1994, Week 4
December 1994, Week 3
December 1994, Week 2
December 1994, Week 1
November 1994, Week 5
November 1994, Week 4
November 1994, Week 3
November 1994, Week 2
November 1994, Week 1
October 1994, Week 5
October 1994, Week 4
October 1994, Week 3
October 1994, Week 2
October 1994, Week 1
September 1994, Week 5
September 1994, Week 4
September 1994, Week 3
September 1994, Week 2
September 1994, Week 1
August 1994, Week 5
August 1994, Week 4
August 1994, Week 3
August 1994, Week 2
August 1994, Week 1
July 1994, Week 5
July 1994, Week 4
July 1994, Week 3
July 1994, Week 2
July 1994, Week 1
June 1994, Week 5
June 1994, Week 4
June 1994, Week 3
June 1994, Week 2
June 1994, Week 1
May 1994, Week 5
May 1994, Week 4
May 1994, Week 3
May 1994, Week 2
May 1994, Week 1
April 1994, Week 5
April 1994, Week 4
April 1994, Week 3
April 1994, Week 2
April 1994, Week 1
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