Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What is the treatment for Munchausen syndrome by proxy?
As the diagnosis of MSBP concludes and moves into treatment, the
involvement of a comprehensive child-protective-services team is considered of
key importance. As with any other instance of child abuse, achieving and
maintaining the safety of the child with the least amount of disruption possible
(in the least restrictive setting) is a central focus. If professionals, family
members other than the perpetrator, and community support systems can
successfully maintain the safety of the victim and any other child in the home,
that may be encouraged. However, if keeping the child in the same home is deemed
to put him or her at continued risk of harm, steps will likely be taken to move
the victim and/or other children in the home to a safer environment. With
effective treatment progress by the victim and the abuser, professionals may
consider slowly reintroducing the child to the home while closely monitoring the
child's safety. In the event that such reintegration is not possible, the child
might be permanently placed outside the home of the perpetrator. In severe
cases, professionals may seek the prosecution and incarceration of the
perpetrator and permanently prevent the abuser's access to the victim.
In working with the child, therapists often teach the victim techniques for
changing dysfunctional ways of behaving while helping the child understand the
underlying feelings and motivations for those behaviors. While psychiatric
medications like antidepressants, anti-anxiety, mood stabilizer, and
antipsychotic medications may be used to alleviate specific symptoms for the
perpetrator or victim, these medications by no means cure the illness
completely.
Individual psychotherapy for both the perpetrator of MSBP and the victim, as
well as family therapy for members of the household involved are often
incorporated into the treatment program. At the same time, the ongoing use of
medical services is closely monitored by medical, mental-health and child-protection professionals. Sometimes, the primary-care doctor will be notified by
the insurance company of future use of medical services by the MSBP victim. The
professional might also be notified when the child is absent from school. Access
to such information is either granted through child protective services or by a
parent. School officials may agree not to excuse an absence unless approved by
the primary-care physician.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Child abuse falls into four categories: neglect, physical abuse, sexual abuse, and emotional abuse. There are certain risk factors that predispose a child to being abused and an adult to abusing a child. Risk factors for children are age, children with learning disabilities, adopted and foster children, children with congenital abnormalities, and a past history of abuse. Parental risk factors include young or single parents, those who suffered abuse themselves, adults with substance-abuse problems or psychiatric disease, and those who didn't graduate from high school.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Munchausen syndrome is a factitious disorder and attention-seeking syndrome in which an individual pretends to have physical or psychological symptoms in order to gain attention. Symptoms and signs vary from heart symptoms, chest pain, and fainting to ear problems and hallucinations. Sufferers tend to seek help from multiple care providers, seem overly pleased at being subjected to tests and procedures, and have vague symptoms that are inconsistent with test results. There is no particular treatment approach that is consistently effective in treating Munchausen syndrome.
Most often, caregivers take care of other adults who are ill or disabled. Less often, caregivers are grandparents raising their grandchildren. The majority of caregivers are middle-aged women. Caregiving can be very stressful, so it's important to recognize when it's putting to much strain on you and to take steps to prevent/relieve stress.
Factitious disorders are conditions in which people pretend to have physical or mental illnesses when they aren't sick. These people may lie about or fake symptoms to obtain the sympathy and attention given to people who are genuinely ill. Symptoms of factitious disorders include dramatic, inconsistent medical history, the presence of many surgical scars, and a history of seeking treatment at many different hospitals.
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