Imputabilidade e dolo na síndrome de münchhausen por procuração : uma interface entre o direito penal e a psiquiatria

Abstract

Münchhausen Syndrome by Proxy (MSBP) is a rare and serious psychiatric condition characterized by the fabrication or induction of symptoms in another person, usually a child. The condition is also known as Child Medical Abuse, Factitious Disorder Imposed on Another, or simply Münchhausen by Proxy. This syndrome can have serious physical and psychological consequences for the victim, as well as significant legal and social implications for the perpetrator. The objective of this work is to review the existing literature on Münchhausen Syndrome by Proxy, addressing the clinical, legal, and psychosocial aspects of the syndrome, and discussing the implications of these aspects for the diagnosis, treatment, and prevention of Münchhausen Syndrome by Proxy. The methodology of this research was carried out through a systematic review of scientific literature, with searches on electronic databases such as PubMed and others, using terms related to Münchhausen Syndrome by Proxy. Review articles, case studies, and epidemiological studies published in the last 73 years were included. The exact prevalence of Münchhausen Syndrome by Proxy is unknown, as it is often underreported and poorly diagnosed. However, studies suggest that it can affect up to 1% of pediatric hospitalizations. The results of the review indicated that MSBP is a rare but potentially fatal condition that requires careful attention from healthcare professionals. The syndrome can be difficult to diagnose as the symptoms are usually vague and nonspecific. Additionally, diagnosis often depends on early detection of the syndrome and identification of the perpetrator's behavior pattern. The literature also highlights the importance of a multidisciplinary approach to MSBP treatment, involving mental health teams, pediatricians, social workers, and lawyers. The review also addresses the legal and psychosocial implications of MSBP for the victim, family, and perpetrator.Caregivers who engage in this behavior can face charges of child abuse and neglect, attempted murder, and even murder. Early diagnosis and adequate treatment can prevent serious physical and psychological harm to the victim and help to stop the perpetrator's behavior. However, greater awareness and training among healthcare professionals and society in general are needed to improve detection and prevention of Münchhausen Syndrome by Proxy.