Suffers of this mental disorder arrange for another person to have fake symptoms of illness and to undergo a barrage of invasive, sometimes painful, tests and treatments. According to one forensic psychologist, they would not admit, even to themselves, that they were causing harm and never acknowledges any negative emotions towards their children. Usually they to not intend to kill, and even in the face of irrefutable evidence would deny that anybody could ever do such a thing. They are not psychotic in the psychiatric sense, but the things they do are absolutely mad. In fact, the sufferer is usually personable and eager to please, and is popular with hospital staff. They appear competent and loving, but in fact have a high incidence of insecurity and uncertainty, as well as low self-esteem. Many are narcissistic and most are highly selfish. Up to a third are illness addicts (MÃ¼nchausen syndrome) themselves, and a high proportion have suffered sexual abuse. Sometimes the whole family may be odd, with a strained marital relationship and the male partner emotionally, if not actually, absent.
Most often the syndrome is seen in mothers, or a mother-substitute, who put a young child through medical torture. Alternatively it can a person "devotedly nursing" an ailing spouse, another family member, or a medical care worker who has ability to administer unprescribed drugs. Cases include mothers overdosing their children with laxatives to produce chronic diarrhoea; poisoning or suffocating in order to induce drowsiness or seizures; contaminating the infant's urine or vomit samples with menstrual blood, raw meat or their own contaminated urine; manufacturing serious illness in youngsters with noxious substances or drugs fed directly through a tube into the stomach, or using the tube to suck back stomach contents so that the child failed to thrive. In hospital they include mothers and carers warming thermometers to give false temperatures, altering charts, and injecting insulin. A recent USA study of 117 victims found that 10 died and a similar number suffered long-term illness. Ten of the victims' siblings were also noted to have died under suspicious circumstances.