Libow, Schreier, & Munchausen by Proxy: Part 6 – First Article

In this series of blog posts, I review the work of Libow & Schreier, early Munchausen Syndrome by Proxy (MSbP) researchers. In my posts up to this point, I talk about their professional backgrounds (as well as my professional background) to provide context. In my last post, I contextualize their work in the broader scientific literature. Now, in this post, I talk about their first co-authored publication together on MSbP, which was in 1986.

Landmark Publication in 1986 in the American Journal of Orthopsychiatry

In 1986, Drs. Libow and Schreier debuted with a landmark publication in the American Journal of Orthopsychiatry entitled, “Three forms of factitious illness in children: When is it Munchausen syndrome by proxy?”

Book with glasses

Unfortunately, I could not get this article. Surprisingly, the article not actually published in the journal of Pediatrics, which I mention in a different series that was a main player in creating the concept of Sudden Infant Death Syndrome (SIDS), which turned out to be a convenient way for MSbP perpetrators to hide the fact that they killed their victims.

Even though Pediatrics is an extremely famous journal, I could not get all the articles for the Proxy Project library from Pediatrics through this time period. Therefore, a little-known article from a less popular journal like the American Journal of Orthopsychiatry was impossible to get.

This particular article from 1986, when I was 15 years old, was not available at the Harvard Medical Library. It’s actually not available. I cannot figure out a way to get it. Don’t get me started on my rant about corruption in access to science; instead, read a more refined version of it here.

Hence, to do justice to their landmark publication, the best I can do is reproduce their abstract here:

“Examples of fabrication of illness in children are described. Primarily uncomplicated cries for help are differentiated from two major subtypes (the Active Inducer and the Doctor Addict) which define the spectrum of Munchausen syndrome by proxy. Primary differences involve the form of deception, age of the victim, and maternal affect. Five histories are presented and it is suggested that doctor addiction is more common than has thus far been recognized.”

This abstract foreshadows what will be a theme in their work, which are articles and books that march through a “case series”, or series of Man feeding babyMSbP cases, describing the symptoms each family had and their treatments, but not really conducting any formal research, qualitative or quantitative.


It is worthwhile to point out that it is not clear what “orthopsychiatry” is, either. Googling for a definition brings up our favorite Oracle, Wikipedia. Lacking scientifically-approved definitions, I turn to Merriam-Webster, who defines it as, “psychiatry concerned especially with the prevention and treatment of mental and behavioral disorders in youth”. I would have never guessed.

In my next posts, I describe the work of Libow & Schreier subsequent to this first publication.

Do you know of an MSbP-related publication we might be missing in the Proxy Project library?

Please let us know about the publication by commenting on this post. We will look it up and see if we can get it!

Image of book and glasses by Darius Sankowski on Pixabay. Photograph of baby by the US Navy.


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