MUNCHAUSEN SYNDROME AND MUNCHAUSEN SYNDROME BY PROXY: AN INTEGRATIVE REVIEW ON DIAGNOSIS, MULTIPROFESSIONAL CARE AND CONTEMPORARY ASSISTANCE CHALLENGES

Abstract

Munchausen syndrome and Munchausen syndrome by proxy are complex psychopathological conditions characterized by the deliberate and repeated fabrication of signs, symptoms, or laboratory abnormalities without any evident secondary gain, as occurs in malingering. These clinical phenomena are difficult to identify and cause physical and psychological suffering either to the individuals themselves, in the self-imposed form, or to third parties under their care, generally young children, in the by-proxy form, now also referred to as factitious disorder imposed on another. This study aimed to conduct an up-to-date integrative review of Brazilian and international scientific literature published primarily over the past decade in order to discuss contemporary diagnostic criteria and the epidemiological, psychodynamic, ethical, and healthcare-related aspects of these conditions. Particular emphasis was placed on the role of the multiprofessional healthcare team as a central component of early diagnosis, therapeutic management, and victim protection, while also critically examining the historical undervaluation of these professionals within care pathways. Electronic databases were searched, and the findings were synthesized qualitatively. The results indicate that, despite the classificatory advances introduced by the fifth edition, text revision, of the Diagnostic and Statistical Manual of Mental Disorders and the eleventh revision of the International Classification of Diseases, significant gaps persist in the epidemiology, systematic screening, and interdisciplinary management of these syndromes, contributing to underdiagnosis, iatrogenic harm, and victims’ prolonged exposure to maltreatment. It is concluded that addressing these conditions requires investment in continuing education, stronger communication protocols across specialties, and effective institutional recognition of the work performed by nursing, psychology, social work, occupational therapy, and the other professional groups involved in healthcare, which have historically been relegated to a supporting role in these decision-making processes.