Munchausen syndrome by proxy (MSBP)

Munchausen syndrome, poetically named in 1951 after German fables of the fictitious Baron Munchausen, denotes factitious or imaginary illnesses intentionally feigned in order to gain access to medical care. The label of Munchausen syndrome by proxy entered the literature in 1977. Confusion about whether it is a diagnosis of the perpetrator or the victim has been recently resolved by distinguishing between “pediatric condition falsification” (PCF), a diagnosis of the victim, some cases of which have other causes, and “factitious disorder by proxy” (FDP), a diagnostic category for the caretaker, referring to fabricating or inducing illnesses in another person in order to assume the sick role by proxy. MSBP is then characterized as the disorder that includes a diagnosis in both the child and the caretaker.

One reason for wishing to abandon the terminology of MSBP is the recognition that a caretaker may be led to fabricate or induce illness in another by a number of different psychiatric disorders, not only through projected Munchausen syndrome. As there is no single psychological profile and the label makes assumptions about the parent's mental state and motivation, the label is gradually falling out of use in clinical contexts, although still common in the popular press and imagination. Further, it appears to be a diagnosis of a parent rather than of the true patient, the child.