CFS/ME an ideal facade for Munchausen syndrome by proxy?—“It can be so exhausting just to relax …”, 2025, Melfsen & Lucas (German)

Sasha said:
Should we maybe not discuss it further on the forum? Could speculation here be damaging?
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Probably fine to discuss the paper and the authors logic and such — but maybe yeah it would probably be best to avoid speculating on what affected Mara and if her relationship with her parents has any effect on her condition. Atleast I wouldn’t feel comfortable discussing that.
 
Jonathan Edwards said:
No. At least in the UK I'm pretty sure that obtaining consent from a ten year old in this context is not legally valid.

I think there are very real concerns about that. Even with a pseudonym cases like this may be recognisable by schoolfriends' families and others later in life.
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I wonder whether a complaint to the journal would be in order?

I knew an adult who read her own highly identifiable medical case in a journal paper that had been written without her consent or knowledge and she was very distressed about it.
 
Many questions remain unanswered in this case. One of them concerns the validity of the diagnosis CFS/ME: Given its currently low validity, does it lead to its use as mimicry in the context of artificial disorders?
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Wouldn’t someone who wants to fake an illness choose something that is less scrutinised than ME/CFS?

  1. Clinic for Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Zurich, Switzerland

    Siebke Melfsen
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I vaguely remember someone mentioning they had an awful experience there as a person with ME on a facebook group.

For images or other information in the manuscript that can be used to identify patients, written consent has been obtained from them and/or their legal representatives.+
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I don’t like the fact the parents could consent for the childhood’s personal info to be put out like that.
 
"Many questions remain unanswered in this case. One of them concerns the validity of the diagnosis CFS/ME: Given its currently low validity, does it lead to its use as mimicry in the context of artificial disorders?"

This seem very confused. In what sense is there 'currently low validity' I wonder? It sounds like they are talking of a fashion in diagnostic couture. How would be 'used as mimicry'? I guess they mean being mimicked. Mimicking something of low validity doesn't make much sense. Maybe the translation is tricky here. 'Artificial disorders' is unfamiliar.

It seems very unclear to me how ME/CFS could be faked by someone else. A parent can bruise a child and claim they have a bleeding disorder. Or starve them and claim they have a wasting disease. But how can one person fake sensitivity to light and sound in another?

What I think the authors may be suggesting is that a child may feel compelled to ape her mother's illness and in doing so lost weight. That would not be MBP.

It may be best to avoid trying to analyse this specific case but I see general implications that perhaps one should have some sort of view on.
 
Sasha said:
Should we maybe not discuss it further on the forum? Could speculation here be damaging?
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This is the relevant rule, with the key part underlined:

Rule 2: Privacy
a) Careful disclosure and discussion of others' personal information
Personal information of identifiable individuals (including information about contact details, health and family) may only be posted if it is either in the public domain, or the member has permission to share it, and if it is posted with care. Posts from other social media that contain personal information may be linked, but should not be screenshot or copied, so the author retains control of the information. Discussion of such personal information must be justified by wider implications relevant to the forum's purpose and should avoid speculation.

I suggest you edit out any speculation about the child or their parent from your posts. Mods will review the thread.
 
Jonathan Edwards said:
I think it is unlikely that a child would become withdrawn, underweight and sensitive to stimuli from eating too many supplements.

It sounds from the story that very likely 'Mara' had ME/CFS. The authors claim that she did not fit the diagnosis but they describe her as if she has it. If she didn't have it, it is unclear what was wrong with her.

This is not MBP to my mind but I think it raises important questions about what effects interpersonal relations might have on a child with ME/CFS, including in terms of prolonging the period of disability.

The authors' analysis fails to shed any light and merely confirms their prior pigeon-hole thinking. But the case may nevertheless be instructive.
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There does feel like a lot of back-filling of post-hoc justification to make them convince themselves the story fits /the chronology is physical illness came last.

I’m surprised someone could write the para about observing their behaviour when at the least the child has been made an inpatient (stressful) if not other stressors or fears likely meaning they’d feel the need to hug when they get to see each other etc. maybe that wasn’t the reason but the author should just know any normal person reading with empathy would need the line to confirm that was above and beyond that insight being factored in.

I agree that the abstract as it is with the title feels irresponsible- even if what is underneath were to be solid gold explanation it’s wrong because of its inference they will know it is having on others with me/cfs. If you don’t note a medical difference between me/cfs and Fdia then you are surely inferring that an fdia diagnosis could be a suspicion only based on the detail given

conbine that with the title and it’s dark ages stuff. Like the days where people justified maltreatment of pwme because some who are just malingerers did choose to pretend they had it’ - neglecting to realise that is fallacial thinking that means it’s incumbent on them to learn to differentiate and understand the condition better not less. So you’d expect detail to show this was well-justified
 
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Jonathan Edwards said:
No. At least in the UK I'm pretty sure that obtaining consent from a ten year old in this context is not legally valid.

I think there are very real concerns about that. Even with a pseudonym cases like this may be recognisable by schoolfriends' families and others later in life.
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Does the notion of Gillick competence come in here (although ill defined)? Gillick competence - Wikipedia

I think if you are relying on parents for consent this is also a dangerous area given threats of child protection around things like ME - it can become forced consent.
 
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