| Abstrakt: |
This section presents the case of a girl who was not recognized as having Munchausen-by-proxy syndrome until she was twelve years old. In this syndrome, a parent--usually the mother, who is often a victim of Munchausen syndrome herself--fabricates or actually causes physical symptoms in her child, for which she seeks medical treatment and often insists on extensive tests and hospitalization. School records dating back to 1981 showed that the girl has been excessively absent from school because of alleged illnesses. It is noteworthy that none of the physicians reported the case to child protective services nor did any obtain child psychiatric consultation. A psychological evaluation of the girl was performed in August 1986, five months after she entered the residential facility. Psychiatric evaluation of the mother revealed serious psychiatric impairment with evidence of schizophrenia and paranoia, which involved a delusional system that led her to seek repeated medical evaluations and treatment of her daughter. The girl was diagnosed as having a somatization disorder and the mother was diagnosed as having schizophrenia, paranoid type, chronic, with Munchausen-by-proxy syndrome. With intensive individual psychotherapy and group therapy, the girl was able to overcome her initial denial of emotional problems and her focus on somatic complaints. |
