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<p>Medical child abuse (MCA) describes a&#xa0;form of child maltreatment in which a&#xa0;child’s symptoms are fabricated, exaggerated, or actively induced by the caregiver. In Munchausen syndrome by proxy (MSBP)—which in International Classification of Diseases (ICD)-11 is defined solely as a&#xa0;perpetrator diagnosis (6D51 Factitious Disorder Imposed on Another)—the focus is on the mental disorder of the perpetrating caregiver. This focus can shift attention away from the affected child and hinder diagnosis in pediatrics. In addition to a&#xa0;factitious disorder, further motives—such as financial gain—or other characteristics and psychopathologies of the perpetrating person (e.g., overprotection, excessive anxiety, personality disorders, psychotic experiences) may contribute to the development of MSBP. These may lead to equally severe consequences and are not always readily recognizable to pediatricians or child and adolescent psychiatrists. At the same time, the healthcare system shares substantial responsibility for perpetuating harm in MSBP when parental accounts are accepted uncritically and unnecessary or burdensome procedures are undertaken. This article sets out why an explicitly child-centered approach is essential to avert severe physical and psychological harm. It also examines the complex background of MSBP and outlines strategies for recognizing manipulated clinical presentations earlier and protecting affected children more effectively.</p>

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Medizinische Kindesmisshandlung – eine pädiatrische Diagnose

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年9月5日

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  • Elisabeth Gobber,
  • Oliver Berthold,
  • Caroline Di Maria,
  • Jo Ewert

摘要

Medical child abuse (MCA) describes a form of child maltreatment in which a child’s symptoms are fabricated, exaggerated, or actively induced by the caregiver. In Munchausen syndrome by proxy (MSBP)—which in International Classification of Diseases (ICD)-11 is defined solely as a perpetrator diagnosis (6D51 Factitious Disorder Imposed on Another)—the focus is on the mental disorder of the perpetrating caregiver. This focus can shift attention away from the affected child and hinder diagnosis in pediatrics. In addition to a factitious disorder, further motives—such as financial gain—or other characteristics and psychopathologies of the perpetrating person (e.g., overprotection, excessive anxiety, personality disorders, psychotic experiences) may contribute to the development of MSBP. These may lead to equally severe consequences and are not always readily recognizable to pediatricians or child and adolescent psychiatrists. At the same time, the healthcare system shares substantial responsibility for perpetuating harm in MSBP when parental accounts are accepted uncritically and unnecessary or burdensome procedures are undertaken. This article sets out why an explicitly child-centered approach is essential to avert severe physical and psychological harm. It also examines the complex background of MSBP and outlines strategies for recognizing manipulated clinical presentations earlier and protecting affected children more effectively.