[Munchausen by proxy qualitative case analysis].

Abstract

Introduction: In 1977, Meadow coined the term Munchausen Syndrome by Proxy (MSBP) to describe a situation in which a parent or caregiver fabricates or induces illness in a child, leading to painful diagnostic procedures and hospital treatments. This can result in both short- and long-term psychological and physiological damage, with potentially severe consequences.

Method: The aim of this study, beyond summarizing the existing literature, is to explore the underlying personality traits, psychological mechanisms, motives, and dynamics associated with MSBP through two case analyses. These analyses are based on a thematic content analysis of exploratory interview material and the results of psychological personality tests (Rorschach, MMPI, SCID-II).

Results: The thematic analysis of the two interviews identified the following common main themes: Background and pre-existing life events (e.g., loss as a traumatic event); Indicators of Munchausen by Proxy (e.g., manipulation of medical records or samples); Personality traits (e.g., theatricality, manipulative behavior, trivialization, relationship dependency, egocentricity); Motivating factors and consequences of Munchausen by Proxy (e.g., illness-related secondary gain).

Conclusion: Both cases shared a history of multiple traumatic events prior to the onset of MSBP-such as bereavement, miscarriage, and abuse - which likely had a significant impact on their personality and emotional state. Another common factor was the close, intense, and symbiotic relationship with the child. However, the cases differed in the degree of aggression involved in inducing illness in the child. In both cases, a diagnosis of personality disorder was confirmed, predominantly with histrionic traits.