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Arch Dis Child. 1996 July; 75(1): 57–61.
PMCID: PMC1511685

Epidemiology of Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation.


A two year prospective study was performed to determine the epidemiology of Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation in the UK and the Republic of Ireland. Cases were notified to the British Paediatric Association Surveillance Unit from September 1992 to August 1994 if a formal case conference had been held for the first time during that period to discuss any of the above conditions. A total of 128 cases were identified: 55 suffered Munchausen syndrome by proxy alone, 15 poisoning, and 15 suffocation; 43 suffered more than one type of abuse. The majority of children were aged under 5 years, the median age being 20 months. On 85% of occasions the perpetrator was the child's mother. In 42% of families with more than one child, a sibling had previously suffered some form of abuse. Eighty five per cent of notifying paediatricians considered the probability of their diagnosis as virtually certain before a case conference was convened. The commonest drugs used to poison were anticonvulsants; opiates were the second commonest. Sixty eight children suffered severe illness of whom eight died. The combined annual incidence of these conditions in children aged under 16 years is at least 0.5/100,000, and for children aged under 1, at least 2.8/100,000.

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Selected References

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  • ASHER R. Munchausen's syndrome. Lancet. 1951 Feb 10;1(6650):339–341. [PubMed]
  • Meadow R. Munchausen syndrome by proxy. The hinterland of child abuse. Lancet. 1977 Aug 13;2(8033):343–345. [PubMed]
  • Morley CJ. Practical concerns about the diagnosis of Munchausen syndrome by proxy. Arch Dis Child. 1995 Jun;72(6):528–530. [PMC free article] [PubMed]
  • Fisher GC, Mitchell I. Is Munchausen syndrome by proxy really a syndrome? Arch Dis Child. 1995 Jun;72(6):530–534. [PMC free article] [PubMed]
  • Meadow R. What is, and what is not, 'Munchausen syndrome by proxy'? Arch Dis Child. 1995 Jun;72(6):534–538. [PMC free article] [PubMed]
  • Rogers D, Tripp J, Bentovim A, Robinson A, Berry D, Goulding R. Papers and originals. Br Med J. 1976 Apr 3;1(6013):793–796. [PMC free article] [PubMed]
  • Dine MS, McGovern ME. Intentional poisoning of children--an overlooked category of child abuse: report of seven cases and review of the literature. Pediatrics. 1982 Jul;70(1):32–35. [PubMed]
  • Meadow R. Fictitious epilepsy. Lancet. 1984 Jul 7;2(8393):25–28. [PubMed]
  • Meadow R. Suffocation, recurrent apnea, and sudden infant death. J Pediatr. 1990 Sep;117(3):351–357. [PubMed]
  • Rosen CL, Frost JD, Jr, Bricker T, Tarnow JD, Gillette PC, Dunlavy S. Two siblings with recurrent cardiorespiratory arrest: Munchausen syndrome by proxy or child abuse? Pediatrics. 1983 May;71(5):715–720. [PubMed]
  • Samuels MP, McClaughlin W, Jacobson RR, Poets CF, Southall DP. Fourteen cases of imposed upper airway obstruction. Arch Dis Child. 1992 Feb;67(2):162–170. [PMC free article] [PubMed]
  • Hall SM, Glickman M. The British Paediatric Surveillance Unit. Arch Dis Child. 1988 Mar;63(3):344–346. [PMC free article] [PubMed]
  • Kemp A, Sibert JR. Drowning and near drowning in children in the United Kingdom: lessons for prevention. BMJ. 1992 May 2;304(6835):1143–1146. [PMC free article] [PubMed]
  • Rosenberg DA. Web of deceit: a literature review of Munchausen syndrome by proxy. Child Abuse Negl. 1987;11(4):547–563. [PubMed]
  • Meadow R. Munchausen syndrome by proxy. Arch Dis Child. 1982 Feb;57(2):92–98. [PMC free article] [PubMed]

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