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is a form of child abuse in which a parent induces the child's real or apparent symptoms of illness or accident situations.

CAUSES, EFFECTS AND RISK FACTORS

This syndrome almost always involves a mother abusing her child looking for him, or herself, medical care. This is a rare and poorly understood cause is unknown. The mother may fake symptoms of illness in her child by adding blood to urine or stool, withholding food, falsifying fevers, administering substances to induce vomiting or diarrhea.

can also use other maneuvers such as infecting intravenous lines for the child appear or become ill.

These children are often hospitalized with groups of symptoms that seemed to fit a classic disease. Often, children are subjected to tests, surgeries or other procedures cumbersome and unnecessary.

In the hospital, the mother is very helpful and appreciated by the nursing staff for the care given to the child. Commonly seen as devoted and self-abnegation rare, making it unlikely that the medical staff suspected the real diagnosis. Her frequent visits also give you easy access to induce more symptoms. Changes in physical examination or vital signs are never witnessed by hospital staff, but almost always occur in the presence of the mother.

Munchausen syndrome occurs because of psychological problems in adults and is usually a behavior that seeks to attract the attention of others. However, the syndrome can threaten the life of the child involved because this unusual behavior can get to the point of serious physical harm and even death. While not an absolute rule is practically rule the parent of the child abuser is the mother, the father being a person without a presence within the family and education of their children. SYMPTOMS



Children usually present with a range of ailments from different organs. The review of the first 20 years of the condition described 68 different symptoms, signs and laboratory findings in 117 cases of Munchausen syndrome, with approximately 70% of induced symptoms or fictitious occurring in the hospital.

Currently, over 100 have reported symptoms. The most common include abdominal pain, vomiting, diarrhea, weight loss, colic, apnea, infections, fevers, bleeding, poisoning and lethargy. One study reported multiple illnesses in 64% of 56 index children who were victims of this evil.

Other reports indicate that some children have the principle with only one serious event such as severe apnea episode with no prior history of manufacturing.

The child's symptoms do not fit any classic disease picture or disagree with each other.
The child's symptoms improve at the hospital but resort to return home.
Blood in lab specimens does not match the patient's blood type.
unexplained evidence of drugs or chemicals in the serum, stool or urine.
overly friendly behavior and "willing" of the mother or father, which may raise suspicions in light of other findings.
Often the person is involved in the health field, such as nursing. Pretending
diseases, injuries and other conditions "pathological" without cause shown. History
dramatic plausible mixture of truths and falsehoods. Wish
exams, investigations, interventions, etc.
Sometimes clinical patterns too typical, like a textbook. Evidence
many procedures (scar, test scores, etc.).
aggressive behavior outside the normal rules of conduct, "sneaky and tricky." Background
many kindnesses and income in many hospitals. High
hospitals upon request, or earlier than recommended.
Non adherence to advice physicians.
Mothers Munchausen syndrome deliberately harm their children and then lie about the origin of the strange ailments to satisfy his sick need for attention, sometimes to save your marriage or the sympathy of others appear as victims.

Children's Hospital Children's Health Care at Scottish Rite, Atlanta, doctors could not find an answer to the repeated revenue in the center of children with unexplained chronic diseases. Dr. David Hall, director of the study, decided four years ago, installing hidden cameras in 41 rooms with suspected cases. Children had suffered such bacterial infections for months were resistant to any treatment. The cameras revealed that the cause was urine that their mothers were injected through intravenous catheters by those who administered the medication. The average age of children was 2 to 3 years, and had it not been for the many hidden cameras may have died. On several occasions, the team that controlled the videos alerted the nurses to come into the rooms. Mothers stopped what they were doing.

Münchhausen mental illness causes many infant deaths worldwide, yet they all caution that it is impossible to give exact figures because of the difficulty with often encounter specialists to diagnose the syndrome. WARNING SIGNS



Warning Signs [edit] The mothers refuse to allow their children to separate from him or someone else to care for them, pretending they are sick and need care.
They are always willing to have your child to have medical tests, treatments and operations, regardless of the consequences.
Other children who have been under the care of the person also suffered from unexplained chronic diseases. According
Munchansen psychologists in the habit of lying becomes a performance so perfect that mothers actually come to believe that are helping their children.

These mothers like the social prestige of a mysterious illness, they like the proximity to the powerful medical professionals, they like the attention and drama, the adrenaline rush of the ER. Besides that, some appear to derive satisfaction from terrorizing their children.

What is Munchausen Syndrome?

Although rare, this syndrome is difficult to detect and confirm. In 1951, Dr Richard Asher used the term "Munchausen syndrome" to describe adults who invented illnesses to get medical care, to adopt the sick role and receive totally unnecessary medical procedures and treatments, but mostly to receive the constant attention of medical personnel and the fame and celebrity of illness "weird" or unknown.

The term was coined in reference to Baron Münchhausen, who was a military mercenary Munchhausen, a region of Lower Saxony, known for tales of fiction and lies on fantastic voyages. The Roy Meadow coined the term Munchausen syndrome to describe a 2 mothers in 1977, lied about symptoms that said two children were suffering, which were caused by them. One of the children had a history of respiratory disease that lasted a long time, from suffocation recurring bloody urine, and the other had a history of hypernatremia (excess sodium in the blood), appellant.

The first child whose symptoms only occurred in the presence of her mother, improved during psychiatric treatment of the mother for their abusive behavior. The second child's symptoms occurred only at home, and he died as a result of severe hypernatremia. In 1994, the doctor reported that the boy's mother admitted to her psychiatrist that she killed her son with salt poisoning. These 2 cases emphasize the importance of early recognition of the syndrome Munchausen by the gravity of its consequences.

In this discussion, we review various aspects of this syndrome, including the prevalence, characteristics of offenders and their victims, complications, diagnosis.

a serious problem

Although not precisely known, the incidence and prevalence of this syndrome is of concern. More than 700 cases have been documented in the English-speaking countries, but they only represent the most severe Munchausen Syndrome. A team of researchers reported variable incidence of the syndrome. One study found that 1% of children with asthma are victims of their mothers with this syndrome.

In another report of children with food allergies, 16 in 301 children (5%) was identified as the victims of this syndrome. In a small English village with a population of 200,000, reported 39 cases of intentional suffocation of children over a period of 20 years (1 in 25,000).

In 1991, Schreier and Libow conducted a study of 880 pediatric neurologists and 388 pediatric gastroenterologists in the U.S. with the proportions of return of 21.8% and 32.4% respectively. Among the 316 doctors who responded to the survey, 212 reported a contact with 192 victims and 273 suspects inveterate Munchausen Syndrome. A Unit study of British Paediatric Association Surveillance found 128 cases of this syndrome, reported in the UK and Ireland over a period of 2 / year, with an incidence of 2.8 per 100,000 children under age 1 and 0 , 5 per 100,000 children under 16 years. Using this criterion, about 625 cases of poisoning and suffocation caused by this syndrome can be expected in the U.S. each year. In more than 95% of cases of Munchausen syndrome, is the mother who causes childhood diseases.

is also known in the world of pediatric medicine under the name of Munchausen syndrome by proxy in allusion.
AS IS


The child's symptoms usually occur only in the presence of the mother, and eat in your absence. It is sometimes called the companion of the mother or other family members and neighbors to give testimony of the "symptoms" from the child.

These events mothers use them to prove the alleged illness of the child to doctors, often described as the most careful and attentive mothers, and of course devoted to their children.

However, not all responsible does this "profile devoted mother" and may also occur as hostile, emotionally weak and obviously unlikely.

Although from then these people can be very deceptive and manipulative. His ability to convince others not be underestimated. The abuse was premeditated, calculated and unprovoked. The mother may have prior knowledge or training in the medical profession and are often fascinated with the medical field. She hopes to establish intimate relationships with medical staff and often becomes a source of support for staff or families of other patients. The mother usually calm before the confusion shows that show the doctors before the mysterious disease that your child is experiencing. She tends to go over the diagnosis and treatments prescribed by a doctor, regardless of pain they can inflict on your child, and often resist the orders of discharge and negative diagnostic results.

The suspicion of a physician or refusal to continue the evaluations can encourage the mother take the child to see another doctor. Mothers who have this syndrome, recognize their inequitable conduct, but take great care to conceal their actions and rarely admit their abusive activities.

mother's partner is often uninterested in the family and rarely plays an active role in child care. Trusting your child's mother, peers can support them and may become passive accomplices ignorantly abuse continued.

In some cases, the abusive mother was suspected of fabricating the symptoms of your child to try their comrade back to the family.

A minority (10-25%) of these women also induce symptoms in themselves. The mother in question rarely has a severe mental illness (like schizophrenia), although it appears that the presence of one or more personality disorders is common.

may also have a family history that was ignored by his parents and was always neglected. The woman's family history may reveal the constant rates of abuse, or rare diseases in family members.

In more than 95% of cases of this syndrome, the mother is to blame for childhood diseases. Studies have reported that, rarely, is the father, the manager in these cases. In these situations, parents are presented as mentally disturbed and unstable. Other types responsible for such abuses, including grandparents, adoptive parents and nannies.

Child abuse usually begins early in life, between 3 to 4 years of age, although victims were older children. A medical report, choking begins between the first and third month of life and lasts between 6 and 12 months or until the patient dies. WHAT

CHILDREN DO?

Older children are often victims of this syndrome confirming conspire with their mothers even more improbable stories about their medical histories, sometimes for fear of contradicting their mothers and others due to the persuasion of their mothers. Some of these children believe they are very ill with a mysterious disorder that doctors can not deduct. In other cases, the child is aware that the mother's explanation is unlikely, but not speak, for fear of retaliation from the mother or no one will believe them.



BROTHERS The brothers may become victims of the abuse by the same parent. In a series studied the deaths of 27 infants who were drowned, 48% had a brother who allegedly died of sudden death syndrome in infants. CONSEQUENCES



The incidence of death and serious medical complications are not known precisely. The rate is presented in a range of 9-31% among the index cases, with most Infoman a mortality rate of 9-10%.

morbidity may be the direct result of abuse or a consequence of multiple diagnostic and therapeutic interventions by the facilitators of the unconscious doctor. In an American clinic reported that it admitted 122 of 128 abused children in the hospital as a result abuse. Of the 128 children, 119 (93%) were unnecessary interventions, 45 suffered serious medical illnesses, 31 minor physical ailments, and 8 died. In an earlier study of 51 infant apnea clinics, 54 of 20,090 children (0.27%) were victims of Munchausen syndrome. 21 of these 54 children received cardiopulmonary resuscitation, and 24 were hospitalized.

The victims of this syndrome are not only induced physical ailments, but can also manifest psychological symptoms produced. Moreover, the impact of abuse of this syndrome is not only physical. Similar to the victims of other types abuse, Munchausen syndrome children also suffer emotional and psychological disorders over time.

Several studies of medical specialists in the subject matter described children who exhibited behavioral problems and even eating disorders in infants, withdrawal, hyperactivity, and disruptive behavior in preschoolers, and conversion symptoms in older children and adolescents . Older children often tolerated and cooperated with their parents in their own abuse and medical illnesses fabricated.

Some of these children deployed behavioral problems that included emotional and behavioral disorders, truancy, fear and withdrawal of specific locations or situations, sleep disorders, nervous disorders and traits. The boys were more disturbances than girls.

Most children who remained with their mothers were exposed to repeated production. Children with "unacceptable results" were largest at the time of abuse and most likely would have been victim to the brothers.


RISK GROUPS

The frequency of the syndrome is low. Predominantly young women and middle-aged, but had referred cases of all ages and both sexes. Some say that the classic syndrome is more common in men. Among the most typical patients, a high percentage of health workers (doctors, nurses and technicians), or personnel related to health services. Patients with Munchausen syndrome often have personality disorders, including little impulse control, self-destructive behavior and borderline personality or pasivaagresiva. It is not entirely clear relationship between this constellation of personality disorders and primary syndrome.

There are reported cases with income over 200 different institutions. Among the "collateral" for these patients often includes the antecedent of the case have been discussed in sessions of staff meetings, conducting diagnostic and treatment procedures of innovative, certified abstracts of medical records, referring to other medical criteria for those who have no evidence, and detailed control of your symptoms, findings and professional opinions. Sometimes exposed to very new ways, you have to those whose safety has not yet been sufficiently established.

care by general practitioners or family is often circumvented or undervalued by these patients, who are chasing the "most qualified specialists in hospitals, which have easier access to technology. MODUS OPERANDI



As examples, there are different cases to tell how "operated" some patients with Munchausen syndrome, or their relatives.

a patient who visited many hospitals in different cities in the United States, was "discovered" after many revenue in U.S. hospitals, which on arrival in each city consulted the phone book, looking for doctors whose specialty attending to patients with the demonstrations that have pretended. He went to hospital and found out what was discreetly on vacation or out of work for a relatively long time. Then called to the Emergency of the hospital, as if the doctor selected recommending that the patient was entered "John Doe" - himself, "with diagnosis X, who was his patient, but now was on vacation, or was out of town, etc.., with such and such recommendations research and therapy.

Another patient with the label of urinary tract infection was 12 hospitalizations, in which he had made 7 pyelograms down, 6 gynecological examinations under anesthesia and 5 cystoscopies. All this without counting the number of antimicrobial treatments. Was found that samples of urine cultures contaminated with cultures of different bacteria, which had access.

Rubbing thermometer produce "fever", the finger-prick drop a few drops of blood in the urine and hematuria appear, rubbing the edges of a wound, and even pollution that does not heal, the excess salt intake cause hypernatremia changing x-rays and other test results are just other examples we can mention a long list of pathogenic mechanisms "that seem more suited to an adventure of Sherlock Holmes, a clinical case.

In other words, when a person is "sick" of this syndrome, is able to do things that sometimes we can not imagine. Patients are literally "crazy" to doctors.

CONSEQUENCES NEGATIVE

As a result of this, the physician - patient relationship is totally altered. The doctor begins to play the role of detective or police officer instead of being capable and caring professional in a position to solve the health problems of their patients. The patient also changes its role, if that subject is going to ask for help, trying to deceive the physician. The result is a tense, antagonistic, difficult. There is a tendency to bother the doctor with the patient, but it seems useful to deal with this without judging.

The ethical situation is very complicated for the physician. Can never 100% sure that the person has "nothing" and you are lying or exaggerating to the max. Experience shows that the more one does for the patient and was "delighted" things will get worse in these cases. There are always new questions, new complaints and is very easy to indicate new evidence or new treatments. Initially, the patient can accept the doctor assigned to his attention when you can not select, "but when the doctor begins to suspect that evidence of the disease are inconsistent, the patient asks to change doctors, which usually professional willingly accepts ("fleeing enemy, the Silver Bridge.") As aforementioned, if the patient shows you that their complaints are uncertain, or has committed "fraud" irritated and often will meet with another doctor or at another institution.

The family impact, social and economic burden of dummy is incalculable. Family gets sick, one way or another. Labor, are a headache. Drinkers are absent.