Munchausen by Proxy Diagnosis

(Also Known As: Factitious Disorder Diagnosis, Malingering Diagnosis, Munchausen Diagnosis)

(Reviewed by: Paul Peterson, Licensed Therapist)

How is Munchausen by Proxy Diagnosed?

In most cases, diagnosis of Munchausen by proxy is very challenging because of the fabricated statements involved. Possible physical illness as the cause of the symptom must be addressed and eliminated from the picture first before making a diagnosis of factitious disorder by proxy.

If physical illness has been ruled out, the doctor will then conduct a thorough evaluation of the medical background of the child. Likewise, they will check on the family background as well as medical history of the mother. Bear in mind that it is the parent or caregiver and not the child who is suffering from factitious disorder by proxy. Thus, a look at all the previous records will be vital and helpful in the diagnosis of Munchausen’s by proxy.

In general, the diagnosis of Munchausen by proxy would include the following:

  1. An evaluation of the history to distinguish fabricated events from real ones
  2. Investigating the temporal connection between the illness and the presence of the parent or caregiver
  3. Verifying the personal, social, and family history provided by the mother.
  4. Conducting interviews with the other members of the family
  5. Determining the motives for such behavior.

In deciding whether child abuse is likely, the evaluating physician must make an accurate evaluation of Munchausen syndrome by proxy. They can consult the Guidelines for Clinical Evaluation of Child and Adolescent Sexual Abuse position paper made by the American Academy of Child and Adolescent Psychiatry.

In determining and evaluating the allegation, the doctor must focus on the broader context. They should have access to all persons and records that will allow the checking of history provided by the mother or other adults.

There are cases when the adult being accused of child abuse is a stranger and evaluating the individual may not be possible. The evaluator must have knowledge of Munchausen by proxy, as well as other conditions that involves child abuse and the guidelines for the determination of abuse.

Could You Have Munchausen By Proxy?

Munchausen By Proxy Topics

Related Conditions

Factitious Disorder – deliberate feigning of symptoms, exaggeration of medical condition
Malingering – faking of symptoms with obvious incentive benefits, exaggeration of medical condition, lying, deception
Munchausen Syndrome – chronic factitious disorder, feigning of symptoms, self induced injury to produce symptoms