Munchausen Syndrome by Proxy (cont.)

Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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As the diagnosis of MSBP concludes and moves into treatment, the involvement of a comprehensive child-protective-services team is considered of key importance. As with any other instance of child abuse, achieving and maintaining the safety of the child with the least amount of disruption possible (in the least restrictive setting) is a central focus. If professionals, family members other than the perpetrator, and community support systems can successfully maintain the safety of the victim and any other child in the home, that may be encouraged. However, if keeping the child in the same home is deemed to put him or her at continued risk of harm, steps will likely be taken to move the victim and/or other children in the home to a safer environment. With effective treatment progress by the victim and the abuser, professionals may consider slowly reintroducing the child to the home while closely monitoring the child's safety. In the event that such reintegration is not possible, the child might be permanently placed outside the home of the perpetrator. In severe cases, professionals may seek the prosecution and incarceration of the perpetrator and permanently prevent the abuser's access to the victim.

In working with the child, therapists often teach the victim techniques for changing dysfunctional ways of behaving while helping the child understand the underlying feelings and motivations for those behaviors. While psychiatric medications like antidepressants, anti-anxiety, mood stabilizer, and antipsychotic medications may be used to alleviate specific symptoms for the perpetrator or victim, these medications by no means cure the illness completely.

Individual psychotherapy for both the perpetrator of MSBP and the victim, as well as family therapy for members of the household involved are often incorporated into the treatment program. At the same time, the ongoing use of medical services is closely monitored by medical, mental-health and child-protection professionals. Sometimes, the primary-care doctor will be notified by the insurance company of future use of medical services by the MSBP victim. The professional might also be notified when the child is absent from school. Access to such information is either granted through child protective services or by a parent. School officials may agree not to excuse an absence unless approved by the primary-care physician.

Source: MedicineNet.com
http://www.medicinenet.com/munchausen_syndrome_by_proxy/article.htm