To discuss some of the challenges presented to the clinician who deals with a possible Munchausen-by-proxy (MBP) syndrome.
The case of an 11-year-old boy presenting with hyperactivity is discussed. Information from the initial assessment and the 9-month follow-up period is presented. We highlight some cultural considerations as they apply to this immigrant family. A commentary by Dr H Schrier follows the presentation.
The positive outcome is discussed in relation to the validation of the diagnosis as well as to cultural issues.
Cultural issues and dynamic factors may be important when we consider the diagnosis of MBP syndrome in an immigrant family with different expectations from our health care system.