Munchausen proxy syndrome

from Wikipedia, the free encyclopedia
Classification according to ICD-10
F68.1 Artificial disorder (deliberately creating or feigning physical or psychological symptoms or disabilities)
T74.8 Other forms of abuse of persons
Y07.- Other abuse
Z61.6 Problems related to suspected physical abuse of a child
ICD-10 online (WHO version 2019)

The Munchausen proxy syndrome (Engl. MSBP Munchausen Syndrome by Proxy , Munchausen by Proxy Syndrome or FDP Factitious Disorder by Proxy ), named after Baron Munchausen , is to design, Bank Increase or actual cause of diseases or their symptoms with third parties , mostly children, mostly in order to subsequently demand medical treatment and / or to take on the role of a seemingly loving and self-sacrificing carer. It is a subtle form of child abuse that can lead to the death of the victim. The perpetrators - 90–95% are women - are mostly the birth mothers. If the victim is an adult, one also speaks of Münchhausen by Adult Proxy Syndrome .

Like the so-called Münchhausen syndrome , the disorder belongs to the group of artificial disorders and has been defined as a separate subtype “unspecified simulated disorder” in the ICD-10 psychiatric classification system . The faked disorder by proxy was initially not included in the DSM-IV (1994), as this could be used to relieve people who abuse children. In the current version of the DSM-5 , however, it is specified under the term “Factitious Disorder Imposed on Another” (301.51) . Diagnostic criteria are also currently being discussed for the future ICD-11 .

Epidemiology

This disorder is relatively rare. However, simulated disorders as such are defined as "probably the most common unrecognized mental illness". The first description was in 1977 by the pediatrician Roy Meadow of the University of Leeds in The Lancet . Since then, several hundred cases have been documented and published worldwide. It is noticeable that this behavior is almost exclusively shown by women - mostly mothers - who are described as loving and caring in their other parenting behavior . According to forensic doctor Martin Krupinski from the University of Würzburg, conservative estimates put 0.2 to 0.4 cases of abuse per 100,000 children and adolescents up to the age of 16. Other sources estimate up to 3 cases per 100,000 children. The mortality rate of the victims is between 5% and 35%, depending on the study.

causes

There is currently no generally accepted explanation for this behavior in the medical literature. Meadow suspected that the motive was the attentiveness and attention to the perpetrator on the part of the relatives and the medical staff (for other possible motives, see Munchausen syndrome ). Often the perpetrators have already committed self- harm in their life stories . Because of this, it is conceivable that the perpetrators will start mistreating children in order not to have to continue to harm themselves. The transitions between Münchhausen syndrome and Münchhausen-by-proxy syndrome can also be fluid and both forms can exist side by side or merge into one another in life history. In some cases, an intergenerational transmission of the Münchhausen-by-proxy syndrome could even be proven. A very close, " symbiotic " relationship with the child seems to be characteristic .

Psychopathology

According to Donna Rosenberg (1987) four characteristics must apply:

  • Illnesses of a child are falsely indicated, simulated or artificially created or maintained by a close reference person, for example the mother.
  • The child is presented, often repeatedly, for medical examinations and treatments.
  • The real causes for the symptoms indicated or shown by the child are not indicated in medical presentations.
  • Any acute symptoms or complaints in the child regress when it comes to separation from the person causing them.

The simulated illnesses often include symptoms or illnesses that cannot or can only be detected with difficulty by the doctor, such as B. epileptic seizures , schizophrenia , bulimia . An almost unlimited number of simulated diseases is conceivable.

It has also been described that female perpetrators deliberately poison their victims , e.g. B. with medication to produce certain symptoms. According to the prevailing opinion, many of the mostly female perpetrators have relatively good medical expertise, are often members of a medical professional group and can also name the symptoms associated with the invented disease upon questioning, so that the character of the "disease" is not noticeable and only the accumulation of Visits to the doctor and the persistence with which treatment is requested or observing the mother's reaction to reports of good or bad results ultimately leads to suspicion.

According to the previous descriptions, the victims are often put under pressure, so that they often confirm the perpetrators' observations during visits to the doctor. Sometimes the perpetrators threatened the victim with suicide ( suicide ). Should the victim break out of the close relationship with the perpetrator, burdened by such threats, the perpetrator often falls into depression .

According to the ASD Handbook on Risk to Child Well- Being , children with invented, simulated or artificially created complaints are not only presented to medical professionals, but also repeatedly to other authorities with authority (e.g. public prosecutor's office, school, youth welfare office, court). False accusations in family court proceedings such as the unfounded allegation of sexual abuse of children are also included in the Munchausen-by-proxy syndrome. The ASD Manual child endangerment recommended in cases of Munchausen by Proxy Syndrome at least a temporary separation of the child from causing parent (more often then improve abruptly the discomfort of the child) and an at least temporary engagement in parental responsibility. A change of custody can also be indicated.

diagnosis

In view of the small number of cases, there is no established and reliable diagnosis or clinically proven treatment of Munchausen deputy syndrome. Due to the relatively high risk of false accusations, the disorder is often not known or the diagnosis is withheld. Video recording is considered to be the safest diagnostic option, although it can only be used in clinical settings. The Austrian child and youth psychiatrist Max Friedrich rejects video surveillance. Assaults outside of medical observation are difficult to detect.

Typically, a perpetrator will continue to see doctors and other specialists until the intended diagnosis is confirmed and appropriate treatment begins.

If a parent endangers the child's well-being by pretending or causing illnesses in the child (Münchhausen-by-proxy-syndrome), the withdrawal of custody is indicated (OLG Celle, February 3, 2006, FamRZ 06, p. 1478).

criticism

Some experts suspect a high number of misdiagnoses of the Münchhausen proxy syndrome, and the existence of the disease as such is also occasionally doubted.

One of the best-known and most fatal misjudgments for the accused was the Sally Clark court case , where the pediatrician Roy Meadow contributed significantly to the mother's conviction of two child homicides with verifiably false probability statements .

Meadow faced an investigation by UK regulators in 2004 after being accused of wrong conclusions in judicial reports. The investigation referred to court opinions that included the likelihood of two cases of sudden infant death in one family. Therefore, in England 258 cases of were infanticide (not specifically MSBP) reopened, where he worked as a consultant.

Some judgments against alleged perpetrators were subsequently overturned. Meadow was reprimanded in 2006 by the UK General Medical Council for incorrectly analyzing statistical probabilities , but his previous removal from the medical register was repealed.

See also

literature

  • Roy Meadow: Munchausen syndrome by proxy: The hinterland of child abuse. In: The Lancet . Vol. 310, No. 8033, 1977, pp. 343-345, doi: 10.1016 / S0140-6736 (77) 91497-0 .
  • JO Warner, MJ Hathaway: Allergic form of Meadow's syndrome (Munchausen by proxy). In: Archives of Disease in Childhood. Volume 59, Number 2, February 1984, pp. 151-156, PMID 6703765 , PMC 1628464 (free full text).
  • Ralph-Martin Schulte (Ed.): Intracorporeal foreign bodies and Münchhausen syndrome. Game types, motivation and complications of self-harm. W. Zuckschwerdt, Munich a. a. 1988, ISBN 3-88603-231-0 .
  • D. Roth: How "Mild" is Mild Munchausen Syndrome by Proxy. In: Israel Journal of Psychiatry and Related Sciences. Vol. 27, No. 3, 1990, ISSN  0333-7308 , pp. 160-167.
  • AB Prakken, L. den Hartog, JJ Waelkens: Een nieuwe variant van het syndroom van Münchhausen by proxy: de vader in een actieve rol. In: Tijdschrift voor Kindergeneeskunde. Vol. 59, No. 3, 1991, ISSN  0376-7442 , pp. 91-94.
  • Toni Single, Richard Leigh Henry: An unusual case of Munchausen syndrome by proxy. In: Australian & New Zealand Journal of Psychiatry. Vol. 25, No. 3, 1991, ISSN  0004-8674 , pp. 422-425, doi: 10.3109 / 00048679109062646 .
  • Abdul Kader Souid, Ken Korins, David Keith, Stephen Dubansky, P. David Sadowitz: Unexplained Menorrhagia and Hematuria: Case Report of Munchausen's Syndrome by Proxy. In: Pediatric Hematology and Oncology . Vol. 10, No. 3, 1993, ISSN  0888-0018 , pp. 245-248, doi: 10.3109 / 08880019309029491 .
  • Herbert A. Schreier, Judith A. Libow: Munchausen by proxy Syndrom: A Modern Pediatric Challenge. In: The Journal of Pediatrics. Vol. 125, No. 6, Part 2, 1994, ISSN  0022-3476 , pp. S110-S115, doi: 10.1016 / S0022-3476 (05) 82934-8 .
  • Stephen J. Boros, Janice P. Ophoven, Robin Andersen, Lauren C. Brubaker: Munchausen syndrome by proxy: a profile for medical child abuse. In: Australian Family Physician. Vol. 24, No. 5, 1995, ISSN  0300-8495 , pp. 768-769, 772-773.
  • Judith A. Libow: Munchausen by proxy victims in adulthood: a first look. In: Child Abuse & Neglect. Vol. 19, No. 9, 1995, ISSN  0145-2134 , pp. 1131-1142, doi: 10.1016 / 0145-2134 (95) 00073-H .
  • Paul DiBiase, Hilary Tirnmis, Jose A. Bonilla, Wasyl Szeremeta, J. Christopher Post: Munchausen syndrome proxy complicating ear surgery. In: Archives of Otolaryngology - Head & Neck Surgery. Vol. 122, No. 12, 1996, ISSN  0003-9977 , pp. 1377-1380, doi: 10.1001 / archotol.1996.01890240083018 .
  • Jenny Gray, Arnon Bentovim: Illness Induction Syndrome. In: Child Abuse & Neglect. Vol. 20, No. 8, 1996, pp. 655-673, doi: 10.1016 / 0145-2134 (96) 00055-5 .
  • Annegret Eckhardt: Artificial disturbances. In: Deutsches Ärzteblatt . Vol. 93, No. 24, 1996, pp. 1622–1626, ( digitized version (PDF; 201.2 kB) ).
  • Roy Meadow: Munchausen Syndrome by Proxy. In: Roy Meadow (Ed.): ABC of Child Abuse. 3. Edition. BMJ, London 1997, ISBN 0-7279-1106-6 , pp. 47-50.
  • Michelle Bryk, Pamela T. Siegel: My mother caused my illness: The story of a survivor of Münchausen by proxy syndrome. In: Pediatrics . Vol. 100, No. 1, 1997, pp. 1-7, doi: 10.1542 / peds.100.1.1 .
  • Klaus M. Keller, Meinolf Noeker, C. Hilliges, Hans-Gerd Lenard, Michael J. Lentze: Münchhausen-by-proxy-Syndrom. In: Monthly Pediatrics . Vol. 145, No. 11, 1997, pp. 1156-1162, doi: 10.1007 / s001120050211 .
  • Kenneth W. Feldman, Robert O. Hickman: The Central Venous Catheter as a Source of Medical Chaos in Munchausen Syndrome by Proxy. In: Journal of Pediatric Surgery. Vol. 33, No. 4, 1998, ISSN  0022-3468 , pp. 623-627, doi: 10.1016 / S0022-3468 (98) 90329-3 .
  • R. Meadow: Munchausen syndrome by proxy abuse perpetrated by men. In: Archives of Disease in Childhood. Volume 78, Number 3, March 1998, pp. 210-216, PMID 9613349 , PMC 1717505 (free full text).
  • R. Meadow: Unnatural sudden infant death. In: Archives of Disease in Childhood. Volume 80, Number 1, January 1999, pp. 7-14, PMID 10325752 , PMC 1717785 (free full text).
  • David E. Hall, Laura Eubanks, Swarnalatha Meyyazhagan, Richard D. Kenney, Sherry Cochran Johnson: Evaluation of Covert Video Surveillance in the Diagnosis of Munchausen Syndrome by Proxy: Lessons From 41 Cases. In: Pediatrics. Vol. 105, No. 6, 2000, pp. 1305-1312, doi: 10.1542 / peds.105.6.1305 .
  • SJ Denny, CC Grant, R. Pinnock: Epidemiology of Munchausen syndrome by proxy in New Zealand. In: Journal of Paediatrics and Child Health. Vol. 37, No. 3, 2001, pp. 240-243, doi: 10.1046 / j.1440-1754.2001.00651.x .
  • Herbert Schreier: On the importance of motivation in Munchausen by Proxy: the case of Kathy Bush. In: Child Abuse & Neglect. Vol. 26, No 5, 2002, pp. 537-549, doi: 10.1016 / S0145-2134 (02) 00329-0 .
  • Mary E. Helfer, Ruth S. Kempe, Richard D. Krugman (Eds.): The abused child. Physical and psychological violence, sexual abuse, failure to thrive, Münchhausen-by-proxy syndrome, neglect. Suhrkamp, ​​Frankfurt am Main 2002, ISBN 3-518-58358-1 .
  • Volker Laubert: Beware of the Münchhausen-by-proxy syndrome - mothers are not witches either (= Aktionrechte für Kinder. Publication series. No. 5). ( online ).
  • Julie Gregory: You made me sick. My mother made me suffer. Ehrenwirth, Bergisch Gladbach 2004, ISBN 3-431-03602-3 .
  • Marc D. Feldman: When people play sick. Munchausen Syndrome and Artificial Disorders. Reinhardt, Munich a. a. 2006, ISBN 3-497-01836-8 .
  • Heinz Kindler, Susanna Lillig, Herbert Blüml, Thomas Meysen, Annegret Werner (eds.): Handbook of child welfare risk according to §1666 BGB and General Social Service (ASD). DJI - Family Department, Munich 2006, ISBN 3-935701-22-5 ( digital version (PDF; 7.16 MB) ).
  • Mary W. Lindahl: Beyond Munchhausen by proxy: a proposed conceptualization for cases of recurring, unsubstantiated sexual abuse allegations. In: Journal of Child Sexual Abuse. Vol. 18, No. 2, 2009, ISSN  1053-8712 , pp. 206-220, doi: 10.1080 / 10538710902758576 .
  • Verena Mertens: The Münchhausen-by-proxy syndrome and its significance under civil and criminal law. In: New legal online journal. No. 20, 2009, ZDB -ID 2082767-2 , pp. 1665-1681.

Issue in popular culture

  • The topic is dealt with in the thriller Devil's Waltz (1993) (German Exit, 1994) by the US author Jonathan Kellerman .
  • In the thriller Hilsen fra Rexville (2011) (German Blutfrost, 2013) by the Danish author Susanne Staun , this disorder plays a central role.
  • The disease was discussed in 2003 in the episode The Black Troll (533) of the ARD series Tatort .
  • Munchausen deputy syndrome is also taken up in the episode worries of a mother of the third season of the RTL series Die Cleveren .
  • In the film Glass House - The Good Mother 1 & 2 (2006) it gradually becomes apparent that the mother is affected by the disorder and becomes a danger to the two foster children.
  • In the Japanese horror film The Call , the disorder appears in the mother of the protagonist and the mother of the antagonist.
  • In the book The Therapy by Sebastian Fitzek it turns out that the protagonist is affected by the disorder and has poisoned his child.
  • The book It Happened Next Door (1994, Heyne-Verlag) by the author Joyce Egginton is a factual report about a mother who killed her eight children and one adopted child due to the disorder.
  • In the book ES of Stephen King , the mother of Eddie Kaspbrak, one of the protagonists suffers from the disorder, and speaks Eddie consequently one to need an asthma spray that turns out in the course of the book as a placebo.
  • The rapper Eminem described in several song texts that he suffered from such a disorder of his mother.
  • The (fictional) band in the film Der Ja-Sager is called "Munchausen By Proxy"
  • The horror film Proxy (2014) tells the story of two mothers, one of whom lost their child, while the other claims to have lost a husband and a child.
  • The disruption was thematized in 2013 in season 2 and later also in season 4 of the Danish-Swedish series The Bridge - Transit to Death .
  • The phenomenon is also touched upon in the novel Shorter Days : Anna Katharina Hahn , Shorter Days , Frankfurt am Main 2009
  • In the novel Cry Baby by Gillian Flynn from 2006 this disorder is also discussed.
  • In the film The Sixth Sense (1999), the girl Kyra is artificially ill with poison from her mother and eventually dies. The act is cleared up by the supernatural powers of the protagonist.
  • In the series Hautnah - Die Methode Hill episode The Trace into Nowhere from Season 5, Münchhausen's deputy is the key to action.
  • In Criminal Minds: Team Red Episode See Nothing, Hear Nothing from Season 1, Munchausen Deputy Syndrome is the perpetrator profile of a nurse who deliberately infects patients with MRSA in order to draw attention to grievances.
  • The 2007 feature film Schattenkinder by Claudia Prietzel and Peter Henning deals extensively with the Münchhausen proxy syndrome.
  • The American series Dr. House deals with the illness as the main diagnosis in the episode "lies and deceit" (S02E09).
  • In the 8-part HBO miniseries Sharp Objects (2018), Munchausen Deputy Syndrome plays a key role in solving several murder cases. The series is based on the novel Cry Baby (2006) by Gillian Flynn.
  • Dee Dee Blanchard claimed for decades that their daughter Gipsy, born in 1991, was seriously ill. The case was very popular in the US , which resulted in a large donation of money to the family. It was only after the murder of Dee Dee Blanchard that it turned out that she had suffered from Munchhausen proxy syndrome. The case was thematized in the documentary film Mommy Dead and Dereast, which appeared in 2017, and in the television series The Act , which first aired on March 20, 2019 .

Remarks

  1. ↑ H. Kindler: What does Munchhausen-by-proxy syndrome mean? In: H. Kindler, S. Lillig, H. Blüml, T. Meysen, A. Werner (Hrsg.): Handbook Child Welfare Risk according to §1666 BGB and General Social Service (ASD). 2006, pp. 7-1–7-5, here pp. 7-2.
  2. ↑ H. Kindler: What does Munchhausen-by-proxy syndrome mean? In: H. Kindler, S. Lillig, H. Blüml, T. Meysen, A. Werner (Hrsg.): Handbook Child Welfare Risk according to §1666 BGB and General Social Service (ASD). 2006, pp. 7-1–7-5, here pp. 7-1.
  3. ↑ H. Kindler: What is known about the connection between intellectual limitations of parents and the development of children? In: H. Kindler, S. Lillig, H. Blüml, T. Meysen, A. Werner (Hrsg.): Handbook Child Welfare Risk according to §1666 BGB and General Social Service (ASD). 2006, pp. 32-1–32-9, here pp. 32-2.

Web links

Individual evidence

  1. ↑ Verena Mertens: The Münchhausen-by-proxy-Syndrome and its civil and criminal meaning. In: New legal online journal. No. 20, 2009, pp. 1665–1681, here p. 1665.
  2. ↑ a b c d e The caring perpetrator. Neue Zürcher Zeitung (NZZ) , No. 43, Zurich (Switzerland), October 26, 2003, accessed: January 30, 2018. (Web archive: The Caring Offender ( Memento from February 11, 2018 in the archive.today web archive ))
  3. ↑ a b "I was addicted to making my child sick" - What goes on in a mother who repeatedly puts her daughter in mortal danger so that she can take care of herself? The story of a woman with Munchausen Deputy Syndrome. In: Brigitte. 26/2015. ( Web archive ( Memento from February 9, 2018 in the web archive archive.today ))
  4. ^ A b R. Meadow: Munchausen Syndrome by Proxy. In: R. Meadow (Ed.): ABC of Child Abuse. 3. Edition. 1997, pp. 47-50, here p. 48.
  5. ↑ a b c d Ulrich Sachsse: Proxy - dark side of motherhood , Schattauer Verlag, September 1, 2015. ISBN 3-7945-3153-1 . About the book presentation: Ulrich Sachsse: Proxy mothers - perpetrators and rescuers at the same time. Special print Psychology Today, at: www.ulrich-sachsse.de/monitor/Dokumente (PDF; 2 p., 151 kB, archived ( memento of March 22, 2019 in the Internet Archive )).
  6. ↑ Therapy Manual: Q 7.2 Artificial Disorders (HJ Freyberger) ( Memento from May 25, 2010 in the Internet Archive )
  7. ^ Diagnostic and statistical manual of mental disorders. DSM-IV. Translated from the fourth edition of the American Psychiatric Association's Diagnostic and statistical manual of mental disorders. Hogrefe, Göttingen u. a. 1996, ISBN 3-8017-0810-1 , p. 541.
  8. ^ Diagnostic and statistical manual of mental disorders. DSM-IV-TR. 4th edition, text revision. American Psychiatric Association, Washington DC 2000, ISBN 0-89042-024-6 , SS 517.
  9. ^ A b Allen Frances, Ruth MA Ross: DSM-IV and ICD-10 case book. Case exercises for differential diagnosis according to DSM-IV and ICD-10. Hogrefe, Göttingen u. a. 2000, ISBN 3-8017-0916-7 , p. 309 f.
  10. ^ Diagnostic and Statistical Manual of Mental Disorders (DSM-5) : "Factitious Disorder Imposed on Another" (301.51)
  11. ↑ Guy E. Brannon, Glen L. Xiong, Ibrahim Abdulhamid, Michael P. Poirier: Factitious Disorder Imposed on Another (Munchausen by proxy). eMedscape, New York, November 11, 2015, ( online ).
  12. ^ Hans-Peter Kapfhammer: Artificial disturbances. In: The neurologist . Vol. 88, No. 5, 2017, pp. 549-570, doi: 10.1007 / s00115-017-0337-8 .
  13. ↑ ICD-11: 6D71 Factitious disorder imposed on another: ICD-11 Beta Draft - Mortality and Morbidity Statistics. icd.who.int, accessed January 30, 2018 (English).
  14. ^ Gregory P. Yates, Marc D. Feldman: Factitious disorder: a systematic review of 455 cases in the professional literature. In: General Hospital Psychiatry. Vol. 41, 2016, pp. 20-28, doi: 10.1016 / j.genhosppsych.2016.05.002 .
  15. ↑ M. Caroline Burton, Mark B. Warren, Maria I. Lapid, J. Michael Bostwick: Munchausen syndrome by adult proxy: A review of the literature. J. Hosp. Med. 2015 January; 10 (1): 32-35.
  16. ↑ a b c VOX : Grausame Mutterliebe , March 17, 2002. youtube.de, accessed on January 28, 2018 .
  17. ↑ a b c ORF : Subject - When parents become a danger , July 4, 2001. youtube.de, accessed on January 28, 2018 .
  18. ↑ a b ABC : Munchausen by Proxy Syndrome , November 1997. youtube.de, accessed on January 28, 2018 .
  19. ↑ Prof. Ulrich Sachsse on the "Münchhausen-Stellvertreter-Syndrome" , Part 1 , Part 2 , Part 3 , Schattauer Verlag on youtube.de, accessed on January 28, 2018.
  20. ↑ Verena Mertens: The Münchhausen-by-proxy-Syndrome and its civil and criminal meaning. In: New legal online journal. No. 20, 2009, pp. 1665–1681, here p. 1666.
  21. ↑ Marion Hofmann-Aßmus: Münchhausen-by-proxy-Syndrom. The mother as the perpetrator. In: Pharmaceutical newspaper . No. 4, 2005.
  22. ↑ The caring perpetrator. In: Neue Zürcher Zeitung . No. 43, October 26, 2003, p. 87 (online [accessed on January 30, 2018] - archive ( memento of March 22, 2019 in the Internet Archive )).
  23. ↑ a b c d e Volker Faust: Pretended health disorders. Psychiatry today, chap. 1, 2017, Arbeitsgemeinschaft Psychosocziale Gesundheit , accessed on February 10, 2018, (PDF, 42 pages, 320 kB).
  24. ↑ Collective reference , see: Dulz et al. (2011), Faust (2017), Institute for Forensic Medicine (2017), Feldman (2004), Bools et al. (1994), Meadow (2002), Hamilton (2008), Noeker (2002), Sachsse (2005), Nowara (2005), Schreier (2004), Schreier & Libow (1993), Bools et al. (1994), Degener & Körner (2005), Sigal et al. (1991) Burton et al. (2015), Burton et al. (2015), Adams & Sutker (2001).
  25. ↑ Birger Dulz, Sabine C. Herpertz, Otto F. Kernberg (eds.): Handbook of borderline disorders. 2nd, completely revised and expanded edition. Schattauer, Stuttgart 2011, ISBN 978-3-7945-2472-3 .
  26. ^ Institute for Forensic Medicine at the University of Leipzig ( Memento from June 26, 2007 in the Internet Archive )
  27. ↑ Meinolf Noeker, Klaus M. Keller: Münchhausen-by-proxy-Syndrom as child abuse. In: Monthly Pediatrics. Vol. 150, No. 11, 2002, pp. 1357-1369, doi: 10.1007 / s00112-002-0608-7 , ( digital copy (PDF; 378.32 kB) ).
  28. ↑ Donna Andrea Rosenberg: Munchausen Syndrome by Proxy: medical diagnostic criteria. In: Child Abuse & Neglect. Vol. 27, No. 4, 2003, pp. 421-430, doi: 10.1016 / S0145-2134 (03) 00029-2 .
  29. ↑ B. Herrmann: Physical abuse of children. Somatic findings and clinical diagnostics. Monthly Paediatrics 2002 (150): 1324-1338, DOI 10.1007 / s00112-002-0610-0 (PDF, 16 pages, 528kb) .
  30. ↑ Child sprayed with contaminated water: young mother accused of child abuse. ra-online GmbH, September 18, 2015, archived from the original on September 25, 2015 ; accessed on September 23, 2015 : " The 30-year-old is said to have administered substances to her son that were mixed with saliva, feces, water from flowers and other foreign substances. The boy spent months in the hospital. At times he was in mortal danger in the intensive care unit. Doctors suspected leukemia until bottles containing the bacteria-contaminated solution were found. “ Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.anwaltsregister.de
  31. ↑ Gert Jacobi, Reinhard Dettmeyer, Sibylle Banaschak, Burkhard Brosig, Bernd Herrmann: abuse and neglect of children - Diagnosis and Management. ( Memento from March 18, 2019 in the Internet Archive ) Deutsches Ärzteblatt, vol. 107, issue 13, April 2, 2010.
  32. ↑ see on the problems of the evidence Verena Mertens: The Münchhausen-by-proxy syndrome and its civil and criminal significance. In: New legal online journal. No. 20, 2009, pp. 1665–1681, here pp. 1678 ff.
  33. ↑ M. Bryk, PT Siegel: My mother caused my illness: The story of a survivor of Münchausen by proxy syndrome. In: Pediatrics. Vol. 100, No. 1, 1997, pp. 1-7.
  34. ↑ David B. Allison, Mark S. Roberts: Disordered Mother or Disordered Diagnosis? Munchausen Syndrome by Proxy. The Analytic Press, Hillsdale NJ 1998, ISBN 0-88163-290-2 .
    Loren Pankratz: Persistent Problems With the Munchausen Syndrome by Proxy Label. In: The Journal of the American Academy of Psychiatry and the Law. Vol. 34, No. 1, 2006, ISSN  0091-634X , pp. 90-95, ( digital version (PDF; 53.76 kB) ).
  35. ^ Helen Hayward-Brown: False and highly Questionable Allegations of Munchhausen Syndrome by Proxy. 7th Australasian Child Abuse and Neglect Conference in Perth 1999.
  36. ↑ John Batts: Stolen Innocence. A Mother's Fight for Justice. The Story of Sally Clark. Ebury Press, London 2005, ISBN 0-09-190569-9 .
  37. ^ Wissenschaft.de: Statistics in the name of the people ( Memento of February 8, 2009 in the Internet Archive )
  38. ↑ Laura Nelson: Quashed convictions reignite row over British cot deaths. In: Nature . Vol. 427, 2004, p. 384, doi: 10.1038 / 427384a .
  39. ^ Sabine Rennefanz : Roy Meadow and the mothers. In: Berliner Zeitung . April 5, 2004, accessed October 31, 2011 .
  40. ↑ Lyrics of Cleanin 'Out My Closet with translation arabrab.ch ( Memento of the original from October 1, 2010 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . @1@ 2Template: Webachiv / IABot / www.arabrab.ch
  41. ↑ Michael Remke: Dee Dee Blancharde and Gypsy: Mother treated daughter like seriously ill . May 27, 2017 ( welt.de [accessed June 5, 2019]).
  42. ↑ Mommy Dead and Dearest. Retrieved June 5, 2019 .
  43. ^ The Act. Retrieved June 5, 2019 .