Munchausen by proxy, now known as factitious disorder imposed on another, is the falsification of symptoms or infliction of injury or disease in themselves or another in the absence of obvious external rewards. People with this disorder often present another person as sick, and it usually involves a parent harming a child.
 
According to The American Professional Society on the Abuse of Children, these are warning signs to look for if you suspect someone may have the condition.
 

1. Reported symptoms or behaviors that are not congruent with observations. For example, the abuser says the child cannot eat, and yet the child is observed eating without the adverse symptoms reported by the abuser.

2. Discrepancy between the abuser’s reports of the child’s medical history and the medical record.

3. Extensive medical assessments do not identify a medical explanation for the child’s reported problems.

4. Unexplained worsening of symptoms or new symptoms that correlate with abuser’s visitation or shortly thereafter.

5. Laboratory findings that do not make medical sense, are clinically impossible or implausible, or identify chemicals, medications, or contaminants that should not be present. An example is a serum sodium level that is not clinically within reason.

6. Symptoms resolve or improve when the child is separated and well protected from the influence and control of the abuser.

7. Other individuals in the home or the caregiver have or have had unusual or unexplained illnesses or conditions.

8. Animals in the home have unusual or unexplained illnesses or conditions –– possibly similar to the child’s presentation (e.g., seizure disorder).

9. Conditions or illnesses significantly improve or disappear in one child and then appear in another child, such as when another child is born and the new child begins to have similar or other unexplained symptoms.

10. Caregiver is reluctant to provide medical records, claims that past records are not available, or refuses to allow medical providers to discuss care with previous medical providers.

11. The abuser reports that the other parent is not involved, does not want to be involved, and is not reachable.

12. A parent, child, or other family member expresses concern about possible falsification or high-healthcare utilization.

13. Observations of clear falsification or induction by the caregiver. This may take the form of false recounting of past medical recommendations, test or exam results, conditions, or diagnoses.
 
For more information, visit The American Professional Society on the Abuse of Children.

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The American Professional Society on the Abuse of Children