Fujiwara Takeo, Okuyama Makiko, Kasahara Mari, Nakamura Ayako
Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan.
Pediatr Int. 2008 Aug;50(4):537-40. doi: 10.1111/j.1442-200X.2008.02613.x.
The purpose of the present paper was to investigate differing characteristics of Munchausen syndrome by proxy (MSBP) between subjects with predominantly physical symptoms and those with predominantly psychological symptoms.
A questionnaire survey was sent to 11 leading doctors in the child abuse field in Japan, each located in different hospital-based sites. Child abuse doctors answered questions regarding the characteristics of MSBP subjects for whom they had helped care. The differences of characteristics between groups were analyzed using Fisher's exact test for categorical variables and Mann-Whitney U-test for continuous variables.
Among 21 reported MSBP subjects, 16 MSBP subjects with predominantly physical symptoms (PHY) and five MSBP subjects with predominantly psychological symptoms (PSY) were found. PHY were more likely to be produced, whereas PSY cases were more often simulated. PHY cases were more often life-threatening than PSY cases, but decisions made by the Child Guidance Center surrounding the custodial outcome of MSBP victims did not differ between PHY and PSY cases.
Social welfare services that need to decide on custody for MSBP victims should recognize the relatively high risk of life-threatening danger of PHY cases in their family of origin.
本文旨在研究代理型孟乔森综合征（MSBP）在以身体症状为主的患者和以心理症状为主的患者之间的不同特征。
向日本儿童虐待领域的11位主要医生发送了问卷调查，他们分别就职于不同的医院。儿童虐待医生回答了有关他们曾照料过的MSBP患者特征的问题。使用卡方检验分析分类变量组间特征差异，使用曼-惠特尼U检验分析连续变量组间特征差异。
在报告的21例MSBP患者中，发现16例以身体症状为主的MSBP患者（PHY）和5例以心理症状为主的MSBP患者（PSY）。PHY多为制造出来的，而PSY病例多为伪装。PHY病例比PSY病例更常危及生命，但儿童指导中心围绕MSBP受害者监护结果所做的决定在PHY和PSY病例之间并无差异。
需要对MSBP受害者的监护权做出决定的社会福利服务机构应认识到，PHY病例在其原生家庭中存在相对较高的危及生命危险的风险。
