Dental Service, KK Women's and Children's Hospital, Singapore.
Faculty of Dentistry, National University of Singapore, Singapore.
Dent Traumatol. 2024 Mar;40 Suppl 2:23-32. doi: 10.1111/edt.12946. Epub 2024 Mar 8.
Munchausen syndrome by proxy (MSbP) is a form of abuse in which a caregiver with Factitious Disorder Imposed on Another (FDIA) fabricates or induces signs or symptoms in a person under their care to satisfy a self-serving psychological need. Unnecessary clinical evaluations, procedures, and treatments that are initiated based on falsification by the abuser inadvertently add to the trauma experienced by the victim. It is a form of abuse and the impact on victims can be severe, sometimes fatal, and far-reaching such as prolonged neglect and extension to affected siblings. The long-term exposure to MSbP may predispose the victim to eventually developing factitious disorder imposed on self (FDIS). While MSbP often involves child victims, elderly, adults, and pets have also been reported as victims. MSbP can be a diagnostic challenge, and the important keys to timely identification of MSbP include the ability to detect deception by caregivers through awareness, clinical suspicion, and careful review of available health records; it also involves collecting collaborative information from other relevant healthcare providers including dentists, schoolteachers, and social workers. To date, there are limited published cases of MSbP with oral findings. This paper provides a narrative review of the current understanding of MSbP with a section on cases with oral findings. This paper aims to increase awareness about the clinical presentations and management considerations for MSbP among dentists and other healthcare professionals.
代理型孟乔森综合征(MSbP)是一种虐待形式,照顾者患有他人为其制造的躯体症状障碍(FDIA),在其照顾的人身上捏造或诱导出现症状,以满足自我服务的心理需求。施虐者伪造的不必要的临床评估、程序和治疗会无意间增加受害者所经历的创伤。这是一种虐待形式,对受害者的影响可能非常严重,有时甚至是致命的,并且影响深远,例如长期忽视和对受影响的兄弟姐妹的影响。长期接触 MSbP 可能使受害者最终发展出自体为自己制造的躯体症状障碍(FDIS)。虽然 MSbP 通常涉及儿童受害者,但也有报道称老年人、成年人和宠物也成为受害者。MSbP 可能是一个诊断挑战,及时识别 MSbP 的重要关键包括通过意识、临床怀疑和仔细审查可用健康记录来检测照顾者的欺骗行为的能力;还包括从包括牙医、教师和社会工作者在内的其他相关医疗保健提供者那里收集协作信息。迄今为止,与口腔发现相关的 MSbP 病例有限。本文通过口腔发现案例部分对 MSbP 的现有理解进行了叙述性综述。本文旨在提高牙医和其他医疗保健专业人员对 MSbP 的临床表现和管理注意事项的认识。