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Munchhausen Syndrome by Proxy with Psychiatric Features

Yann Auxemery

Although Munchhausen syndrome by proxy (MSP) with somatic expression is a familiar diagnosis to paediatricians and psychiatrists, the psychiatric form has remained more confined to the literature. This clinical form is distinguished by the allegation of artificial psychiatric disorders to convince others that a child suffers from these disorders. After an update on the classic form of MSP via somatic expression and its diagnostic issues, we present a brief review of the literature to explain the peculiarities of MSP with psychiatric expression. We detail the psychological complications for the child through a case report and analysis that illustrate the difficulty of identifying this particular disorder, the treatment of which is complex. The delay in diagnosis is several years, during which time the symptoms can be recast to mask a psychiatric reaction to this particular form of abuse. The suffering of the child and his parents will be shortened if the diagnosis is quickly established and the appropriate treatment is instituted.