eMedicine Specialties > Psychiatry > Psychosomatic

Munchausen Syndrome by Proxy: Differential Diagnoses & Workup

Author: Guy E Brannon, MD, Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company
Coauthor(s): Kimberly S Carroll, MA, Clinical Research Coordinator, Brentwood Research Institute
Contributor Information and Disclosures

Updated: Jan 17, 2008

Differential Diagnoses

Factitious Disorder
Malingering

Workup

Laboratory Studies

Standard medical workup for Munchausen syndrome by proxy is unlikely to provide useful information, other than findings that exclude medical conditions that could account for psychiatric pathology in the parent.

Laboratory tests may include these:

  • Sequential multiple analysis
  • Determination of the CBC count
  • Assays for rapid plasma reagent, thyroid-stimulating hormone, and thyroid function

Toxicologic tests and DNA typing might also be indicated.

Imaging Studies

Perform CT scanning or MRI if intracranial pathology is likely or if findings from neurologic examination are abnormal.

Other Tests

  • Psychological testing may be performed to help clarify the diagnosis.
  • A separation test removes the mother from her child for the purpose of observation. In Munchausen syndrome by proxy, the child's medical condition typically improves in the parent's absence, or the child may develop new abnormal findings or worsen after a visit with the parent.
  • If indicated, obtain an electroencephalogram.

More on Munchausen Syndrome by Proxy

Overview: Munchausen Syndrome by Proxy
Differential Diagnoses & Workup: Munchausen Syndrome by Proxy
Treatment & Medication: Munchausen Syndrome by Proxy
Follow-up: Munchausen Syndrome by Proxy
References
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References

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  35. Von Burg MM, Hibbard RA. Munchausen syndrome by proxy: a different kind of child abuse. Indiana Med. Sep-Oct 1995;88(5):378-82. [Medline].

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Further Reading

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Keywords

Münchhausen syndrome by proxy, MSBP, Munchausen syndrome, Munchausen syndrome emergency, Munchausen syndrome by proxy emergency, Asher, Baron von Munchausen, Polle syndrome, Polle's syndrome, children of Munchausen, pediatric condition falsification, PCF, FD, factitious disease, factitious disorder, factitious disorder by proxy, factitious disorder not otherwise specified, factitious disorder NOS

malingering, psychiatric disorder, pseudosickness, pseudologues, mental disorder, child abuse emergency, physical child abuse, tampering, infection of unknown origin, unexplained death, feigned illness, faked illness, hospital hobo, pathomimicry disease forgery, doctor addicts, hospital addicts, hospital hoppers, professional patients, false patients, operation addicts, peregrinating problem patients, dissociative pseudologia fantastica, hypochondriasis, hypochondriacs, black-hole patients, fabricated symptoms, invented symptoms, personality disorders, somatoform disorder, sudden infant death syndrome

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Contributor Information and Disclosures

Author

Guy E Brannon, MD, Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company
Guy E Brannon, MD is a member of the following medical societies: American Medical Association, American Medical Writers Association, American Psychiatric Association, American Society of Addiction Medicine, Association of Clinical Research Professionals, Louisiana State Medical Society, and Southern Medical Association
Disclosure: AstraZeneca Honoraria Speaking and teaching; Takeda Honoraria Speaking and teaching; Wyeth Honoraria Speaking and teaching; Janssen Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Coauthor(s)

Kimberly S Carroll, MA, Clinical Research Coordinator, Brentwood Research Institute
Disclosure: Nothing to disclose.

Medical Editor

Ronald C Albucher, MD, Chief Medical Officer, Westside Community Services; Consulting Staff, California Pacific Medical Center
Ronald C Albucher, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Eduardo Dunayevich, MD, Adjunct Assistant Professor, Department of Psychiatry, University of Cincinnati; Clinical Research Physician, Neuroscience, Lilly Research Laboratories
Eduardo Dunayevich, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; BMS Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Other; Northstar Grant/research funds Other; Novartis  Other; Pfizer Honoraria Speaking and teaching

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

 
 
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