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Psychiatry Miscellaneous 545e719b

"Munchausen's syndrome" by proxy involves:

A
Drug - abuse
B
Toxin - mediated neuropsychiartic disease
C
Illness caused by Care giver
D
All of the above
High-Yield Explanation
Ans. C. Illness caused by Care-giver. (Ref: Kaplan & Sadock's Synopsis of Psychiatry, Xth/Ch. 34.3, pg. 923).Munchausen's syndrome by proxy involves illness caused by Care-giver.In Munchausen syndrome by proxy, a caregiver, usually the mother, fabricates or produces symptoms of illness in a child. The caregiver's motive is to vicariously receive care and attention from health providers through the sick child. The severity of the disorder varies from cases in which symptoms are completely fabricated to cases in which the mother causes serious physical harm to or even the death of the child. Mothers in cases of Munchausen by proxy are extremely attentive to their children and often are considered model parents. These mothers are not cognitively impaired or psychotic; on the contrary, they are often quite accomplished and knowledgeable and frequently work or have worked in the medical field. Not infrequently, more than one child is victimized in a family, particularly in cases of suffocation disguised as sudden infant death syndrome (SIDS) or apnea. A very pathological relationship develops between the mother and the victimized child, to the point that older chil- dren often collude with the mother in producing the symptoms.Munchausen syndromeChronic factitious disorder with predominantly physical signs and symptoms. Characterized by a history of multiple hospital admissions and willingness to receive invasive procedures.Munchausen syndrome by proxyWhen illness in a child or elderly patient is caused by the caregiver. Motivation is to assume a sick role by proxy. Form of child/elder abuse.Factitious disorderPatient consciously creates physical and/or psychological symptoms in order to assume "sick role" and to get medical attention (1deg gain).

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