Síndrome de Munchausen por poderes

Abstract

Munchausen Syndrome by proxy (MSP) is a particular form of child abuse whose seriousness results from its high rate of morbidity and mortality, difficult diagnosis and posterior management. In last years different terminological approaches have been made to designate it.. During the last eight years we have diagnosed 6 cases of MSP. In all of them the casual agent was the mother, presenting an important deterioration in her family and nearly 50% of cases with alterations in the personality. Victim's medium age was 8,4 years, with a period of 34 months until the diagnosis was confirmed and more than 20 medical consultations during that time. Although it is not our experience, it has been reported a high rate of presenting long term consequences in child development, even death. We propose to establish an Interdisciplinary Team. Some points that must be dealt with by the team are to establish an alternative "entrance door" to the hospital other than that of the emergency services, decide the moment of confronting the family, taking legal measures and creating a long term intervention-monitoring plan.