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Munchausen Syndrome by Proxy

Department of Pediatrics, State University of New York, Health Science Center, Syracuse, New York

David V. Keith, MD

Department of Psychiatry, State University of New York, Health Science Center, Syracuse, New York

Allan S. Cunningham, MD, FAAP

Department of Pediatrics, State University of New York, Health Science Center, Syracuse, New York

Munchausen syndrome by proxy is the most difficult form of child abuse. It carries substantial morbidity and mortality. The diagnosis relies on appropriate suspicion and careful investigation. The psychological illness/need of the perpetrator is the main clinical feature. Early recognition and appropriate intervention prevent further abuse and criminal actions.

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