06.03.2021

Delegated Munchausen Syndrome

The reason for hospitalization was always a mysterious ear infection: a child was diagnosed with small inflammatory nodules in the tissues of the ear canal, which prevented doctors from examining his eardrum. In addition to the mysterious nodules, strange discharge from the ears was discovered in Mario.

Doctors had no choice but to put the child a rather superficial diagnosis – “inflammation of the middle ear.”

The main thing here is not to be confused with Munchausen’s syndrome, in which the patient is trying by all possible means to pretend to have some kind of disease or disorder. Alas, the victims of the delegated syndrome are usually children and not all of them survive.

One of the most striking cases of this dangerous disease was the story of a Chilean boy named Mario. Doctors at the hospital. Carlos van Buren in Valparaiso noticed a frightening pattern. So for his three years, the baby managed to visit here five times, and it was about the last nine months of the life of little Mario.

Hospitalization also involved an aggressive course of antibiotics, which had a rather negative effect on the overall development of the child. For his age, the kid spoke very poorly and for some reason lagged behind his peers in development.

As soon as Mario was in the hospital, his condition stabilized almost instantly, but after discharge the baby fell ill again. In 2016, an article appeared in the Chilean medical journal Revista de otorrinolaringología y cirugía de cabeza y cuello (Journal of Otolaryngology and Surgery of the Head and Neck) that made it possible to take a fresh look at this mysterious affliction. So the hospital’s doctors simply could not understand the most important thing – the obvious reason why the ear infection returned to the baby again and again.

And doctors were alarmed by the blurred clinical picture of a mysterious disease – the presence of atypical pathogens and small wounds in the ear of their patient. The answer turned out to be shocking and incomprehensible. The truth was discovered quite by accident, when a roommate saw at night how Mario’s mother injected something to her baby.

Prior to this, the attending physician had already suggested that a certain family factor might have been present in this story, and that the mother herself laid some kind of irritating substance to her child. But social services and a child psychiatrist considered such a hypothesis utter nonsense, although at that time the child had already spent 80 days in this hospital.

But mother Mario really looked very alarmed and concerned about the health of her child. “She (mother) was very worried. She always accompanied him, always arrived in advance and spent almost round the clock in the hospital, ”says one of the doctors.

Despite threats from her neighbor, the woman was not afraid to tell what she saw. Doctors called the police, who found syringes and other suspicious objects in the small patient’s room. Then the prosecutor immediately issued a warrant forbidding the sick mother to approach her child. As soon as the woman stopped “caring” for her son, the boy immediately went on the mend. For the first time, doctors were able to examine their patient’s eardrum. Guesses were confirmed – little Mario had no illness.

Subsequently, the doctors of this hospital will establish that it was not Mario himself who was ill, but his mother. It was a question of delegated Munchausen syndrome – a disease diagnosed in 1977 by British pediatrician Roy Meadow.

So, what is this strange kind of dangerous syndrome? With the usual Munchausen syndrome, a person begins to invent various diseases for himself, not shying away from imitating the corresponding symptoms with medications, often inflicting injuries on himself. Why is this done? The main goal is to arouse sympathy and compassion on the part of doctors.

So in the case of delegated syndrome, the patient does not fabricate the symptoms of the disease in himself, but in the person for whom he is responsible. Most often we are talking about children whose mothers or guardians want the medical staff and the environment to admire their dedication. A type of syndrome is extremely difficult to diagnose, so many children seriously suffer from this type of violence from their loved ones. 7% of such cases result in the death of a defenseless “patient”.

In world practice, there are many cases where parents were convicted of causing symptoms of certain diseases in their children. Various medications often cause vomiting or diarrhea. Sometimes caring guardians and parents injected the child with blood, urine or even feces. All this led to numerous biopsies, as well as surgical intervention. It is extremely difficult to recognize such a cunning disease, because doctors quite rarely suspect caring parents of causing intentional harm to their child.

In the case of Mario, his attending physician nevertheless began to guess the nature of the mysterious illness, but he could prove his point of view only by chance. There is another important and sad aspect, which does not allow us to identify the bulk of such cases. We all well understand that medical care costs quite a lot of money, so re-hospitalization usually goes into the hands of our healthcare…

There is no reason to believe that in Russia, the delegated Munchhausen syndrome is absent as a phenomenon. Alas, most of these scary parents are dangerous and cunning manipulators. According to Chilean doctors, in the vast majority of cases, it is the mother who carries out the violence in this situation.

Quite often, such sadists themselves experienced violence in childhood, someone was abandoned by their parents or simply did not receive attention from relatives. A psychological vacuum can develop into a strong need to feel increased attention to your person. And who should be compassionate than the poor mother of a sick baby?

The delegated Munchausen syndrome was also reflected in the cinema. So in the luxurious Swedish TV series “Bridge” it will not be clear to us in the first season why the main character is so out of this world. For many years, the Saga fought a terrible enemy – a mother who almost cured her sister to death. The consequences of such a relationship are terrible – the grown up children themselves become a psychiatrist’s dream.

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