Background: Munchausen’s Syndrome By Proxy (MSBP) is a particular and potentially lethal form of child abuse, with reported mortality rates of about 10%. By definition, MSBP occurs when an adult repeatedly produces symptoms and/or signs of illness in a child under his/her responsibility, causing unnecessary medical investigations/treatments/hospitalisations. The syndrome was discovered by R. Meadow in 1977, and since then, more than 400 cases have been reported in the international literature. Objective: Aim of the present study is to evaluate the latest 15-years research on MSBP, outlining main trends of the specific literature and main publishing attitudes. Method: A descriptive bibliometric analysis was performed. Through the MeSH database of NIH PubMed, the definition of MSBP was selected (A phenomenon in which symptoms of a disease are fabricated by an individual other than the patient causing unnecessary, and often painful, physical examinations and treatments. This syndrome is considered a form of CHILD ABUSE, since another individual, usually a parent, is the source of the fabrication of symptoms and presents the child for medical care). From the databank, in the period 1990-2005, all articles strictly referring to this definition were retrieved. For each record retrieved, data were collected on authors, source (journals have been subdivided by subject area), publication year, publication type, language, pages, abstract. All the information was recorded in a dedicated database. Results: In the whole 15-years period considered, 385 articles were extracted from the database MEDLINE/Pubmed. The most profit-bearing year was 1995, with the 12.6% of the whole period production. In the “hit-parade” of journals, Child Abuse & Neglect classed first with a 7%, followed by Archives of Diseases in Childhood and BMJ (with 5,6 % and 5,3%, respectively). Mostly North-American and European journals are at stake. The subject area mostly involved is the Medical (83%, mainly general medicine and paediatrics) followed by Nursing (11%), Psychology (3%). Looking at languages, 44% of articles are written in English, 19% German, 5% in Spanish. More than 44% are single-author articles (range=0-10; mean= 2.16; SD=1.6; variance= 2.55). On what attains authorship, the most prolific writers are sir R. Meadow and H. A. Schreier. The mean number of pages per article is 5,3 (range 33-1); evaluating number of pages in time, it is clear that at the beginning there were more articles with a lower number of page, while in the last years the situation is reversed (more pages, less articles) attesting probably a sort of quality knowledge consolidation. Case Report is the most declared type of publication (58.4%), followed by Review (36.7%), Observational Population-Based Study represent less than 1% of all manuscripts. Conclusion: MSBP represents a great challenge in the broad field of child abuse and neglect, diagnosis is frequently delayed mostly for the pleomorphic nature of this disease and, detection is much more difficult, since even if there are few typical aspects of the diseases, there are no exclusive signs or symptoms. MSBP results in being still extremely underreported and understudied and unknown in many of its aspects. Being the manuscripts mainly case reports, only partial conclusions can be drawn on the syndrome, especially from and epidemiological point of view and this extreme fragmentariness of knowledge and the information gap can not be ignored.

Munchausen's Syndrome By Proxy at a Glance: Twisting an Old Tale

ROSA RIZZOTTO, MELISSA;FACCHIN, PAOLA
2006

Abstract

Background: Munchausen’s Syndrome By Proxy (MSBP) is a particular and potentially lethal form of child abuse, with reported mortality rates of about 10%. By definition, MSBP occurs when an adult repeatedly produces symptoms and/or signs of illness in a child under his/her responsibility, causing unnecessary medical investigations/treatments/hospitalisations. The syndrome was discovered by R. Meadow in 1977, and since then, more than 400 cases have been reported in the international literature. Objective: Aim of the present study is to evaluate the latest 15-years research on MSBP, outlining main trends of the specific literature and main publishing attitudes. Method: A descriptive bibliometric analysis was performed. Through the MeSH database of NIH PubMed, the definition of MSBP was selected (A phenomenon in which symptoms of a disease are fabricated by an individual other than the patient causing unnecessary, and often painful, physical examinations and treatments. This syndrome is considered a form of CHILD ABUSE, since another individual, usually a parent, is the source of the fabrication of symptoms and presents the child for medical care). From the databank, in the period 1990-2005, all articles strictly referring to this definition were retrieved. For each record retrieved, data were collected on authors, source (journals have been subdivided by subject area), publication year, publication type, language, pages, abstract. All the information was recorded in a dedicated database. Results: In the whole 15-years period considered, 385 articles were extracted from the database MEDLINE/Pubmed. The most profit-bearing year was 1995, with the 12.6% of the whole period production. In the “hit-parade” of journals, Child Abuse & Neglect classed first with a 7%, followed by Archives of Diseases in Childhood and BMJ (with 5,6 % and 5,3%, respectively). Mostly North-American and European journals are at stake. The subject area mostly involved is the Medical (83%, mainly general medicine and paediatrics) followed by Nursing (11%), Psychology (3%). Looking at languages, 44% of articles are written in English, 19% German, 5% in Spanish. More than 44% are single-author articles (range=0-10; mean= 2.16; SD=1.6; variance= 2.55). On what attains authorship, the most prolific writers are sir R. Meadow and H. A. Schreier. The mean number of pages per article is 5,3 (range 33-1); evaluating number of pages in time, it is clear that at the beginning there were more articles with a lower number of page, while in the last years the situation is reversed (more pages, less articles) attesting probably a sort of quality knowledge consolidation. Case Report is the most declared type of publication (58.4%), followed by Review (36.7%), Observational Population-Based Study represent less than 1% of all manuscripts. Conclusion: MSBP represents a great challenge in the broad field of child abuse and neglect, diagnosis is frequently delayed mostly for the pleomorphic nature of this disease and, detection is much more difficult, since even if there are few typical aspects of the diseases, there are no exclusive signs or symptoms. MSBP results in being still extremely underreported and understudied and unknown in many of its aspects. Being the manuscripts mainly case reports, only partial conclusions can be drawn on the syndrome, especially from and epidemiological point of view and this extreme fragmentariness of knowledge and the information gap can not be ignored.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11577/1556186
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