Munchausen Syndrome by Proxy Presentation

Munchausen syndrome by proxy (MSBP) is a serious form of child abuse in which the perpetrator is typically the victim’s maternal caregiver. Assessing for MSBP can be very challenging for medical providers due to symptom mimicry and a dearth of information about the disorder. This Integrative Review seeks to shine a light on common symptomatology of MSBP and to make sure that providers leave it on the differential diagnosis until alternative diagnoses can effectively exclude it. A total of 240 records from online databases were reviewing for content, currency, and rigor. This search was narrowed to 10 records for in-depth review. The literature review revealed common features of MSBP. These included high morbidity and mortality, atypical clinical presentation, an omnipresent female caregiver, and symptom improvement and/or resolution upon separation from caregiver. When left off the differential diagnosis in cases where the clinical picture “does not add up,” providers could be unintentionally missing signs of abuse. The discussion focuses on how providers can integrate and use these findings within their clinic while promoting early detection and diagnosis of MSBP.