NCJ Number
216008
Journal
International Journal of Offender Therapy and Comparative Criminology Volume: 50 Issue: 3 Dated: June 2006 Pages: 245-254
Date Published
June 2006
Length
10 pages
Annotation
This article presents a case study of an adult female exhibiting signs of Munchausen syndrome by proxy with subsequent stalking behavior.
Abstract
Munchausen syndrome by proxy is described as a factitious disorder by proxy wherein a caretaker, usually the mother, induces illness in her child in an effort to gain attention and nurturance for herself. This case study involved a 32-year-old divorced mother of 2 children who had a history of more than 17 psychiatric hospitalizations beginning at age 18 when she was diagnosed with major depression with psychotic features. The patients’ long medical and psychiatric history is described which include diagnoses of schizoaffective disorder, borderline personality disorder, and hypothyroidism. The patients’ legal history is similarly reviewed and includes charges of aggravated menacing and assault on a child protective caseworker. Possible explanations for Munchausen syndrome by proxy in this patient are offered and include possible sexual abuse as a child, although the veracity of the sexual abuse claims were unable to be verified. Diagnostic challenges to treating this patient are considered and relate to questions concerning the truthfulness of her self-reported psychological symptoms and inconsistent findings from psychological assessments and behavioral observations. Despite the questions concerning her diagnoses, treatment with the medication clozapine improved the patients symptoms, as did later treatment with a high dose of quetiapine combined with chlorpromazine. During psychotherapy, the patient steadfastly has reported that she no longer feels impulses to harm her children. The Epilogue reports that the patient is doing well living in a group home and has established relationships with her children. References