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Breast J 2019 Apr 13. Epub 2019 Apr 13.

Breast Cancer Center, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

Behav Neurol 2019 3;2019:3891809. Epub 2019 Mar 3.

Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

Background: Systematic studies on factitious disorders and malingering in large populations are rare. To address this issue, we performed a nationwide epidemiological study in Norway on the incidence of these diagnoses in an unselected patient population. In particular, we tried to confirm the diagnoses and to estimate the contribution of Munchausen syndrome to the spectrum of factitious disorders. Read More

Geriatr Nurs 2019 Mar - Apr;40(2):214-216. Epub 2019 Mar 11.

Riddle Medical LLS, Tarrytown, NY, USA.

Clin Child Psychol Psychiatry 2019 Jan 9:1359104518816122. Epub 2019 Jan 9.

Yale School of Medicine, USA.

Clinical practice guidelines for informing children they have been subjected to caregiver-fabricated illness are highly limited in the current literature. This article addresses this issue by offering an ethically informed, psychological approach to the disclosure of this form of abuse to school-aged children and adolescents who have been significantly harmed. A multidisciplinary, staged model of communication which illustrates that truthful communication with children and their families is a necessary component of the recovery process is proposed. Read More

Lupus 2019 Feb 7;28(2):249-252. Epub 2019 Jan 7.

1 Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Childhood-onset systemic lupus erythematosus (cSLE) is a chronic inflammatory multisystem autoimmune disease that requires multiple differential diagnoses. Munchausen by proxy syndrome (MBPS) is a form of child abuse, where a caregiver intentionally creates a medical history and induces or fabricates signs or disease in a patient. To our knowledge, there is no case report of MBPS mimicking cSLE diagnosis. Read More

Saudi J Ophthalmol 2018 Oct-Dec;32(4):353-354. Epub 2018 Sep 24.

Emergency Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Munchausen's Syndrome is a factitious disorder in which patients manipulate physicians through misrepresented signs and symptoms. The authors describe an 18-year-old woman with self-induced inoculation of ant's particles inside her conjunctival fornices of both eyes. The crushed particles was confirmed to be crushed ant's particles. Read More

BMC Emerg Med 2018 12 11;18(1):53. Epub 2018 Dec 11.

Northeast Georgia Medical Center Barrow, 316 N Broad St, Winder, GA, 30680, USA.

Background: Factitious disorder causing hypoglycemia is a psychiatric condition in which patients deliberately use blood sugar lowering medications to cause severe symptoms for the purposes of hospitalization or other primary gains.

Case Presentation: We report a case of factitious hypoglycemia in a 19-year-old foster care adolescent female who presented to the Emergency Department with recurrent hypoglycemic episodes, to the degree that the patient required large amounts of dextrose and further management by intensive care unit hospitalization. Further inquiry revealed that the patient intentionally injected herself with large doses of insulin for the purposes of seeking hospital admission. Read More

Indian Dermatol Online J 2018 Nov-Dec;9(6):435-437

Department of Psychaitry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Munchausen syndrome by proxy (MSBP) is a rare psychiatric disorder of a caregiver (commonly mother) who induces injury or symptoms on victim because of his or her psychiatry illness. The victims are usually under 6 years of age who cannot complain regarding inflicted injury. Diagnosis is challenging to the physician. Read More

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018 Dec;61(12):1587-1602

Zentrum für Kinderheilkunde, Universität Bonn, Bonn, Deutschland.

Interviewing a child of a suspected abuse (physical abuse, sexual abuse, neglect, Munchausen-by-proxy syndrome) is subject to complex risks of suggestion and distortion. The use of a standardized interview protocol as part of the investigation can significantly increase the scope and validity of the child's report in different settings (for example, pediatrics, child welfare services, court).In this paper, the interview protocol provided by the National Institute of Child Health and Human Development (NICHD) in its revised and complete version is presented in German and made available for free clinical use in the Appendix. Read More

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018 Dec;61(12):1579-1586

Zentrum für Kinderheilkunde, Universität Bonn, Bonn, Deutschland.

Doctors and especially paediatricians in clinics and private practices are often the first professionals to be confronted with the suspicion of a child endangerment (sexual abuse, physical abuse, neglect, Munchausen-by-proxy syndrome). They thus play a key role in the early assessment and clarification of suspicion and setting the course for the further interdisciplinary procedure.The clinical investigation of a suspicion is a diagnostic and communicative challenge. Read More

Nurs Clin North Am 2018 09;53(3):375-384

University of Arizona, College of Nursing, 1305 N. Martin Avenue, Tucson, AZ 85721, USA.

Munchausen syndrome and Munchausen syndrome by proxy are complex diseases that are difficult to diagnose and treat. To assist in this process, an overview of diagnostic criteria with common characteristics and red flags are discussed, with case studies illustrating identification and diagnosis of these disorders. Treatment options are addressed within the context of each of these complex syndromes. Read More

J Pediatr Adolesc Gynecol 2018 Dec 7;31(6):637-639. Epub 2018 Jul 7.

Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.

Background: Medical child abuse is a challenging diagnosis to make, particularly in older children with unusual presenting symptoms.

Case: A 7-year-old child with complex medical history presented with anogenital bleeding of unknown origin. Extensive laboratory testing, imaging studies, and diagnostic procedures were negative for any etiology. Read More

Palliat Support Care 2019 02 27;17(1):119-121. Epub 2018 Jun 27.

Medical Oncology Department,Centre Oscar Lambret,Lille,59020,France.

Objective: Cancer patients can present with impossible behavior, which can jeopardize their treatment and challenge healthcare professionals' teamwork.

Method: Report of two unusual psychiatric cases, including Munchausen and Peter Pan syndromes, which occurred in a comprehensive cancer center.ResultGuidelines in medical and surgical wards are suggested to address such situations regarding oncologic compliance. Read More

Am J Case Rep 2018 Jun 27;19:752-756. Epub 2018 Jun 27.

Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, Netherlands.

BACKGROUND Pediatric condition falsification (PCF) is a rare form of child abuse in which a caregiver fabricates or induces illness in the child. The diagnosis is difficult and controversial and can easily include false positives. CASE REPORT A boy, 3. Read More

Clin Ter 2018 May-Jun;169(3):e129-e134

University of Padua, Department of Molecular Medicine.

Munchausen syndrome by proxy is a relatively rare behavioral disorder affecting a child's primary caregiver, typically the mother. Ethical dilemmas that physicians may face in such situations mainly concern the medical options for best protecting the child's welfare, that are important, in clinical pediatric practice, because critical conflicts might arise between health professionals and parents. In such cases, the physician's primary obligation is to protect the children involved, whose family environment may be essential to their wellbeing. Read More

Paediatr Int Child Health 2018 Jun 8:1-3. Epub 2018 Jun 8.

a Department of Pediatric Surgery , Children's Hospital Bechir Hamza , Tunis , Tunisia.

Fabricated and/or induced illness (previously known as Munchausen syndrome by proxy) is a form of child abuse in which the perpetrator induces, exaggerates or fabricates illness in his/her child. Two-month-old twins were referred to the paediatric surgery centre with trocar needles lodged in different organs. A radiograph undertaken in one of them because of acute respiratory distress demonstrated needles in the heart and diaphragm which were removed surgically. Read More

Curr Pharm Biotechnol 2018 ;19(2):99-112

Clinical Analysis Department, Hospital Universitari Son Llatzer, Balearic Islands Health Research Institute (IdISBa), Palma de Mallorca, Spain.

Background: Clinical and forensic toxicology can be defined as two disciplines involving the detection, identification and measurement of xenobiotics in biological and non-biological samples to assist in the diagnosis, treatment, prognosis and prevention of poisonings and to disclose causes and contributory causes of fatal intoxications, respectively.

Objective: This article explores the close connections between clinical and forensic toxicology in overlapping areas of interest.

Methods: An update has been carried out of the following seven areas of interest in analytical toxicology: doping control, Sudden Cardiac Death (SCD), brain death, Sudden Infant Death Syndrome (SIDS) and Munchausen Syndrome by Proxy (MSBP), prenatal exposure to drugs and Fetal Alcohol Syndrome (FAS), Drug-Facilitated Crimes (DFC) and intoxications by new psychoactive substances (NPS). Read More

Front Pediatr 2018 18;6:110. Epub 2018 Apr 18.

Section of Child and Adolescent Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.

Factitious Disorder Imposed on Another (FDIA), also known as Munchausen Syndrome by Proxy (MSbP) is a very serious form of child abuse. The perpetrator, usually the mother, invents symptoms or causes real ones in order to make her child appear sick. Usually this is due to a maladaptive disorder or to an excessive of attention-seeking on her part. Read More

Soc Hist Med 2017 Aug 6;30(3):567-589. Epub 2016 Oct 6.

Concepts used by historians are as historical as the diagnoses or categories that are studied. The example of Munchausen syndrome (deceptive presentation of illness in order to adopt the 'sick role') is used to explore this. Like most psychiatric diagnoses, Munchausen syndrome is not thought applicable across time by social historians of medicine. Read More

Arch Dis Child 2019 Feb 4;104(2):110-114. Epub 2018 Apr 4.

Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK.

Int J Environ Res Public Health 2018 03 29;15(4). Epub 2018 Mar 29.

Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06100 Perugia, Italy.

Background: In most of the cases regarding children, factitious disorders (FDs) are intentionally produced by parents. Less attention is paid to FDs in which a child or adolescent intentionally induces or falsifies the disease to attain a patient's role.

Case Presentation: A 13-year-old immigrated and adopted boy previously underwent an operation for renal joint syndrome and was affected by recurrent episodes of renal colic. Read More

Vertex 2017 Mar;28(132):145-151

Servicio de Salud Mental Instituto de Investigaciones Médicas "A. Lanari", Facultad de Medicina, UBA.

We present a detailed case report that shows a woman patient who has Factitious Disorder manifested by the coexistence both of: A) typical/direct Munchausen and B) Munchausen by proxy or indirect: being the frst one (A) about the own person and the second one (B) about other people (most cases about their own young children). Furthermore, in the reported case we observed that the patient shown the particularity of having positive biological markers for Myasthenia Gravis (serology markers), and having inconsistent clinical manifestations that are typically observed in the exacerbation phase when she still continued in remission phase. In our own bibliographic research we couldn`t fnd anything about this case of "Mixed Munchausen Syndrome with organic comorbidity". Read More

Vestn Otorinolaringol 2018;83(1):72-74

L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.

The authors describe a rare clinical case of psychogenic hearing loss in a female patient presenting Munchausen's syndrome with special reference to the objective and subjective methods designed to evaluate the hearing ability and used for diagnostics of this condition. Read More

Einstein (Sao Paulo) 2017 Oct-Dec;15(4):516-521

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

The Munchausen syndrome and Munchausen syndrome by proxy are factitious disorders characterized by fabrication or induction of signs or symptoms of a disease, as well as alteration of laboratory tests. People with this syndrome pretend that they are sick and tend to seek treatment, without secondary gains, at different care facilities. Both syndromes are well-recognized conditions described in the literature since 1951. Read More

J Anal Toxicol 2018 04;42(3):e35-e37

Institut de medicine légale, 11 rue Humann, F-67000 Strasbourg, France.

Hand Surg Rehabil 2018 Apr 29;37(2):110-113. Epub 2017 Dec 29.

Service de chirurgie plastique et chirurgie de la main, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.

Every doctor can be confronted, during his career, with patients presenting symptoms they created themselves. Because it is easily accessible, the hand is a favored target organ for these self-inflicted injuries. The diagnosis of factitious disorder of the hand is very difficult, rarely suggested and widely under-estimated. Read More

Psychol Res Behav Manag 2017 11;10:387-394. Epub 2017 Dec 11.

Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy.

A systematic search for all case reports and case series of adult patients with factitious disorders (FD) in the databases MEDLINE, Scopus, and PsycINFO was conducted. FD is a psychiatric disorder in which sufferers intentionally fabricate physical or psychological symptoms in order to assume the role of a patient, without any obvious gain. The clinical and demographic profile of patients with FD has not been sufficiently clear. Read More

Anaesthesia 2018 01;73(1):124

Health Education North West (Mersey), Liverpool, UK.

Indian J Psychol Med 2017 Sep-Oct;39(5):671-674

Department of Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.

Munchausen syndrome by proxy (MSBP) is a form of child abuse that describes children whose parents or caregivers invent illness stories and substantiate the stories by fabricating false physical signs. Through this case report, a serial MSBP case is presented along with psychiatric evaluation of the perpetrator mother who was sent to the Forensic Psychiatric Observation Department of the Council of Forensic Medicine to assess whether she has any mental disorder. Although there are several studies on MSBP, we present this case because the perpetrator mother was caught on the camera surveillance system of the hospital while closing the nose and mouth of the victim for fabricating the illness, and she also said that she had done the same thing to her two elder children to exclude their illnesses. Read More

Dent Update 2017 Mar;44(3):261

Front Neurol Neurosci 2018 17;42:81-86. Epub 2017 Nov 17.

Since its initial description in 1851, Munchausen syndrome has been widely used interchangeably with factitious disorder. Nevertheless, this syndrome is only one form of factitious disorder that is both severe and chronic. The syndrome was named after Karl Friedrich Hieronymus, Baron von Münchhausen (1720-1797), a German nobleman who became famous as a narrator of false and exaggerated exploits. Read More

Acta Med Iran 2017 Aug;55(8):525-529

Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy.

A 47-year-old woman presented with a history of resistant arterial hypertension, associated with disabling headache. She was subjected to an enormous number of tests in order to identify an underlying cause of secondary hypertension, such as pheochromocytoma or Cushing syndrome, but all the most common causes of secondary hypertension were investigated and gradually excluded. Factitious use of amphetamine or cocaine was excluded, and therapy compliance was verified by witnessed ingestion of drug therapy, in order to rule out Munchausen syndrome. Read More

Cureus 2017 Jun 13;9(6):e1348. Epub 2017 Jun 13.

Department of Medicine, FMH College of Medicine and Dentistry.

Munchausen syndrome (MS) was first reported in 1951 by Richard Alan John Asher as a factitious disorder. It is a condition in which the patient intentionally produces symptoms to assume a sick role and gain medical attention. Underdiagnosis of this disorder results in the unnecessary use of medical resources, i. Read More

Cureus 2017 Jun 12;9(6):e1339. Epub 2017 Jun 12.

Psychiatry, Kings County Hospital Center.

A case history of an 18-year-old female with a diagnosis of Munchausen syndrome is presented with a literature review of this rare syndrome. We present this case because of the young age and the patient's overwhelming response to cognitive behavioral therapy. We recommend collateral history taking, exclusion of all possible etiologies and detailed briefing of family members as it plays a vital role to reduce the mental and financial suffering of the patient. Read More

Z Orthop Unfall 2017 Aug 16;155(4):477-498. Epub 2017 Aug 16.

Despite modern conservative and surgical procedures, the number of amputations of the lower limb remains at a consistently high level. With the demographic changes and the consequent prevalence of atherosclerosis and diabetes mellitus, there is a steady increase of the risk factors that can lead to an amputation. The cause, which ultimately leads to the loss of the affected limb is therefore a symptom of the underlying disease. Read More

Chest 2018 Feb 8;153(2):528-543. Epub 2017 Aug 8.

Division of Pulmonary, Critical Care, Allergy and Immunology, Department of Medicine, Wake Forest University School of Medicine and Wake Forest Baptist Medical Center, Winston-Salem, NC; Division of Allergy and Clinical Immunology, Department of Medicine, W.G. (Bill) Hefner VA Medical Center, Salisbury, NC; Division of Allergy and Clinical Immunology, Department of Medicine, Kernersville Health Care Center, Kernersville, NC. Electronic address:

Anaphylaxis is a systemic, life-threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or nonallergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal, and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest, resulting in hypoxemia and/or shock. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2017;117(4. Vyp. 2):84-90

Sechenov First Moscow State Medical University, Moscow, Russia.

According to current criteria, the diagnosis of psychogenic motor defect is based on the tests which allow recording of movements in the pseudo-paralyzed extremity. Using polysomnography, electromyography and videomonitoring of motor activities during sleep, movements in the pseudo-paralyzed left arm were recorded in a patient with Munchhausen syndrome and psychogenic plegia in the left arm. A reduced motor activity in the left side of the body, in particular in the pseudo-paralyzed arm was observed as well. Read More

J Forensic Sci 2018 May 2;63(3):771-775. Epub 2017 Aug 2.

School of Psychology, University of Central Lancashire, Preston, UK.

In Munchausen by proxy (MBP) maltreatment, increasingly termed "medical child abuse" (MCA), a caregiver fabricates or induces illness in another. The perpetrator's goal for the behavior is to meet personal emotional needs by forcing unnecessary or misguided medical or psychological treatment. Generally, a mother is the perpetrator and her child is the victim. Read More

Child Abuse Negl 2017 Oct 24;72:45-53. Epub 2017 Jul 24.

Department of Psychological Medicine, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom. Electronic address:

Introduction: Little is known about the perpetrators of medical child abuse (MCA) which is often described as "Munchausen's syndrome by proxy" or "factitious disorder imposed on another". The demographic and clinical characteristics of these abusers have yet to be described in a sufficiently large sample. We aimed to address this issue through a systematic review of case reports and series in the professional literature. Read More

Neurology 2017 Jul;89(3):307

Lübeck/Hamburg, Germany.

Neurology 2017 Jul;89(3):307

Recife, Brazil.

Nephrol Ther 2017 Nov 9;13(6):482-484. Epub 2017 Jun 9.

Service de néphrologie rhumatologie dermatologie pédiatriques, centre de référence des maladies rénales rares, hôpital Femme-Mère-Enfant, hospices civils de Lyon et université Claude-Bernard Lyon 1, 3, quai des Célestins, 69002 Lyon, France.

Munchausen syndrome by proxy is a persistent fabrication of illness done by a person to another. Renal and urologic forms of this syndrome are not as uncommon as can be thought; a review of all the cases of Munchausen-by-proxy syndrome reveals that 25% of the children had renal or urologic issues. This syndrome can result in a serious diagnostic dilemma for the physicians; knowing this entity can allow early recognition of falsification and limit the physical and psychological damages caused in the victim. Read More

Ann Saudi Med 2017 May-Jun;37(3):245-250

Mohammed A. Gogandy, MD, Anterior Segment Unit,, Department of Ophthalmology,, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia M: 00966553553889 ORCID: orcid.org/0000-0003-1455-2677.

Individuals with a factitious ocular disorder feign or exaggerate having an eye injury or intentionally produce an eye injury so as to assume the role of a sick person. We report two cases of self-inflicted ocular injury using needle-like foreign bodies and razor that represent possible diagnoses of Munchausen syndrome. Both patients presented with different clinical pictures that misguided the clinical diagnosis and delayed proper management. Read More

Noro Psikiyatr Ars 2017 Mar 1;54(1):87-89. Epub 2017 Mar 1.

Clinic of Child and Adolescent Psychiatry, Bakırköy Psychiatric Hospital, İstanbul, Turkey.

A factitious disorder (FD) is a diagnostic entity in which patients intentionally act physically or mentally ill without obvious benefits and without being consciously aware of a clear underlying motive. Most pediatric FD cases have been reported as Munchausen syndrome by Proxy; however, pediatric disease symptoms can also be intentionally falsified by child and adolescent patients. To our knowledge, in the medical literature, an FD patient presenting with stuttering has not been previously reported. Read More

Tidsskr Nor Laegeforen 2017 May 23;137(10):696-697. Epub 2017 May 23.

J Trop Pediatr 2018 02;64(1):78-81

University of Ribeirão Preto, São Paulo 14027-150, Brazil.

Objective: To describe a case of an obese child whose weight gain was related to the Munchausen Syndrome by proxy (MSP).

Methods: This is a case report including information regarding the child's clinical history and the mother's behavior. The common features of the syndrome are confronted with the description of the case, seeking to demonstrate the similarities. Read More