Munchausen syndrome by proxy: a narrative review on the perpetrator figure
Main Article Content
Abstract
Munchausen Syndrome by Proxy is a type of child abuse, of a rare and unusual nature, which is extremely dangerous for the child. It is also designated as a mental disorder, so it is the perpetrator who receives the diagnosis. The perpetrator figure is defined as narcissistic, hysterical and manipulative, exhibiting pathological lying, which is in line with other personality disorders. Although this is his/her reality at heart, his/her behavior is revealing of too much care and protection towards the child in the presence of others. It s diagnosis is difficult to achieve due to the inherent characteristics of the disorder, to the characterization of the perpetrator’s profile, but also due to the lack of perception by the health professional. This study aims to characterize the perpetrator and his/her behavior. The methodology used includes a narrative literature review and the analysis of some case studies that reveal the predictor behavior. The clear, objective and judicious definition is expected to arouse the curiosity and interest of several professionals in order to boost research, as the literature is not unanimous about the constructs governing this pathological condition. Finally, it is expected to contribute to health care professionals developing skills to timely diagnose this behavior and remain alert to the perpetrator’s friendly manipulative behaviors, without harming the child victim.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
References
American Psychiatric Association (DSM-V). (2013). Somatic Symptom and Related Disorder. In Diagnostic and statistical manual of mental disorders. DSM-5 (5a edição, pp. 309–329). American Psychiatric Association.
Artingstall, K. (2017). Munchausen by Proxy and Other Factitious Abuse: Practical and Forensic Investigative Techniques. Taylor & Francis.
Bass, C., & Jones, D. (2011). Psychopathology of perpetrators of fabricated or induced illness in children: case series. The British Journal of Psychiatry, 199(2), 113–118. https://doi.org/10.1192/BJP.BP.109.074088
Bezerra, L. de C., Leite, A. A. V. M., Ribeiro, A. V. G., Ponte, D. M., Rolim Neto, M. L., & Paula, J. dos A. de. (2020). The importance of Health Professionals’ information of Munchausen Syndrome by Proxy: A Systematic Review. Saúde Coletiva (Barueri), 10(58), 3943–3950. https://doi.org/10.36489/saudecoletiva.2020v10i58p3935-3950
Criddle, L. (2010). Monsters in the closet: Munchausen syndrome by Proxy. Critical Care Nurse, 30(6), 46–55. https://doi.org/10.4037/ccn2010737
Cujiño, M. F., Dávila, A., Sarmiento, M. M., Villarreal, M. I., & Chaskel, R. (2012). Síndrome de Munchausen por poder. Revista Latinoamericana de Psiquiatría, 11(2), 60–65. https://www.medigraphic.com/pdfs/psiquiatria/rp-2012/rp121f.pdf
Gómez, E. E. (2021). Desenhos de investigação qualitativa. In S. P. Gonçalves, J. P. Gonçalves, & C. G. Marques (Eds.), Manual de Investigação Qualitativa: Conceção, Análise e Aplicações (1.a ed., pp. 3–23). Pactor.
Gonçalves, I. M., Pimentel, T. de C., Moura, R. S., Siqueira, B. da R., Pimentel, F. de C., Ferreira, V. L., & Gonçalves, S. J. da C. (2021). O transtorno factício das síndrome de Munchausen e síndrome de Munchausen por Procuração: uma revisão narrativa de literatura. Revista Eletrônica Acervo Saúde, 13(11), 1–7. https://doi.org/https://doi.org/10.25248/REAS.e9072.2021
Libow, J. A., & Schreier, H. A. (1986). THREE FORMS OF FACTITIOUS ILLNESS IN CHILDREN: When Is It Munchausen Syndrome by Proxy? American J. Orthopsychiatric Association, INC, 56(4), 602–611. https://doi.org/https://doi.org/10.1111/j.1939-0025.1986.tb03493.x
Lovaglio, G. S., & del Bagge, P. L. (2021). Síndrome de Münchausen por poderes. Alto riesgo para la vida de niños, niñas y adolescentes. Revista de Psicología, 082, 1–15. https://doi.org/10.24215/2422572xe082
Meadow, R. (1977). MUNCHAUSEN SYNDROME BY PROXY THE HINTERLAND OF CHILD ABUSE. The Lancet, 310(8033), 343–345. https://doi.org/10.1016/S0140-6736(77)91497-0
Meadow, R. (1989). ABC of Child Abuse MUNCHAUSEN SYNDROME BY PROXY. BMJ, 299, 248–250.
Miziara, C. S. M. G., Serrano, V. A. G., Ferro, E. Z., & Miziara, I. D. (2020). Doença fabricada ou induzida pelos cuidadores: maus-tratos graves e silenciosos. Saúde, Ética & Justiça, 25(1), 28–31. https://doi.org/10.11606/issn.2317-2770.v25i1p28-31
Nathanson, M. (2018). Münchausen syndrome By Proxy. In C. Rey-Salmon & C. Adamsbaum (Eds.), Child Abuse: Diagnostic and Forensic Considerations (pp. 303–312). Springer. https://doi.org/https://doi.org/10.1007/978-3-319-65882-7
Rosenberg, D. A. (1987). Web of deceit: a literature review of Munchausen syndrome by proxy. Child Abuse & Neglect, 11(4), 547–563. https://doi.org/10.1016/0145-2134(87)90081-0
Silva, H. M., & Priszkulnik, L. (2013). Síndrome de Munchausen por procuração, a Psicologia e a Psicanálise: conhecer para suspeitar. Psicología, Conocimiento y Sociedad, 3(2), 155–170. https://www.redalyc.org/pdf/4758/475847410008.pdf
Simão, J. S. S., Sousa, H. F. de L., Feitosa, B. F., Santos, A. C. dos, Nogueira, L. M., & Costa, S. de S. (2020). EDUCAÇÃO EM SAÚDE PARA AGENTES COMUNITÁRIOS DE SAÚDE SOBRE A SÍNDROME DE MUNCHAUSEN, UM RELATO DE EXPERIÊNCIA EXTENSIONISTA. Revista Ciência Em Extensão, 16, 243–250.
Sousa Filho, D. de, Kanomata, E. Y., Feldman, R. J., & Neto, A. M. (2017). Síndrome de Munchausen e síndrome de Munchausen por procuração: uma revisão narrativa. Einstein (Sao Paulo, Brazil), 15(4), 516–521. https://doi.org/10.1590/S1679-45082017MD3746
Taskforce - APSAC. (2018). Munchausen by proxy: Clinical and case management guidance. APSAC Advisor, 30(1), 8–31. http://www.apsaclibrary.org/publications_all.php?dir=2018%20Number%201
Telles, L. e. de B., Moreira, C. G., Almeida, M. R., Mecler, K., Valença, A. M., & Baldez, D. P. (2015). Transtorno factício imposto a outro (síndrome de Munchausen por procuração) e maus-tratos infantis. Revista Debates Em Psiquiatria, 38–43. https://doi.org/https://doi.org/10.25118/2763-9037.2015.v5.154
Tetzlaff, A. A. da S., & Gomes, J. A. (2020). Aplicativo móvel para identificação da Síndrome de Munchausen por procuração para o aporte da enfermagem forense. Global Academic Nursing Journal, 1(3), 1–9. https://doi.org/10.5935/2675-5602.20200059
Tozzo, P., Picozzi, M., & Caenazzo, L. (2018). Munchausen Syndrome by Proxy: balancing ethical and clinical challenges for healthcare professionals Ethical consideration in factitious disorders. In La Clinica terapeutica (Vol. 169, Issue 3, pp. 129–134). https://doi.org/10.7417/T.2018.2067
Vecina, M. C., & Jiménez-Perianes, A. (2020). Aproximacion teorica al Sindrome de Munchausen por Poderes. Behavior & Law Journal, 6(1), 6–11. https://doi.org/https://doi.org/10.47442/blj.v6.i1.77
Vilelas, J. (2020). Investigação - o processo de construção do conhecimento (M. Robalo, Ed.; 3a ed.). Edições Sílabo.
World Health Organization (ICD-11). (2022). International Classification of Diseases (ICD-11) 11th Revision: For Mortality and Morbidity Statistics. https://icd.who.int/browse11/l-m/en