Münchausen syndrome by proxy

[DrGachet]

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Anybody has dealt with this before? In the clinic where I do research, one of the subjects (who did not meet the criteria for our study) was there with his dad and he was quite...something. Everybody knows him there. Apparently he has borderline personality or something, but he's definitely more of the narcissistic blaming subtype than the slash-my-wrist-if-you-leave-me kind. In any case, he's quite a character but I've never met someone with Münchausen syndrome by proxy, so who knows....

 

[whopper]

This diagnosis is quite rare and difficult to diagnose. I had someone that I believed was on the spectrum of it but not quite enough for it. The person had a daughter with William's Syndrome. This mother was trying to have her daughter become a celebirty by using the genetic disorder as a way to push her on television.

Was she harming her daughter? IMHO yes, though I don't think a court of law would see it that way. She was not physically harming the person, but she kept feeding the idea to her daughter that she was a star and that her disorder could lead to worldwide love, fame and wealth. The daughter, not surprisingly, developed factitious disorder and was the only patient I've had ever that had combined factitious disorder and malingering.

A colleague of mine did have someone that fit the diagnosis. That person was drawing blood from her daughter and it took hospital staff a few days to figure out that the mother was actually doing it.

 

[Chimed]

We had a grandmother (the legal guardian) bring a 13 yo pt to our hospital for an ECT work-up of "treatment resistant" psychosis. They initially went to a big name hospital, who refused to do ECT on her. We accepted her to our hospital for an ECT evaluation. GM gave this long story of how the pt was psychotic and dangerous. The pt also had Mild MR and Fetal EtOH Syndrome. She was on a boatload of medications including 2 anti-psyhotics and an anti-depressant. Pt said she heard "voices", but her story seemed to change several times. The pt, however, was very slowed and had a difficult time communicating--negative/cognitive sx's from early schizophrenia? GM also said her Mom had schizophrenia. One of the first things we did was strip all her meds off and kept GM out of the hospital during the day. Low and behold...Her cognition improved, she was brighter, and she stopped talking about voices. It seemed liked many of the her sx's were side-effects from the meds. We thought this was great, but GM was not happy! She started claiming that we were mistreating her and insisted that we still do ECT b/c her GD was "psychotic and very, very dangerous." It was very confusing. The girl was very sweet, passive, and docile. There absolutely no evidence of psychosis. The only time she agreed to her voices was after GM would look at her and prod her saying "Now I know you're hearing voices, come on sweety, tell them what you hear." The pt would then agree that she was hearing voices. However, without GM around, there was no such talk and she certainly wasn't responding to internal stimuli.

It started getting nastier between GM and the clinical team. GM started calling other hospitals asking for an ECT evaluation. We became convinced that GM had Münchausen proxy. We ended up calling her original state and it turned out that GM had her admitted over 12 times in one year to various hospitals. GM wanted to take the pt out AMA. We ended up calling CPS. Unfortunately, despite everything we did and getting legal involved, we had to release the pt to GM. It was very sad...