RESUMO
We present a comprehensive overview of the condition factitious disorder by proxy, also known as Munchausen syndrome by proxy. The review begins by highlighting essential definitions and the etiology and epidemiology of the disorder. It then analyzes relevant clinical issues such as assessment and diagnostic methods. The final section is a detailed discussion of the complex issues facing the clinician, including the process of confronting the perpetrator, relevant legal issues, and the treatment of the caretaker, child, and family through a multidisciplinary, team approach.
Assuntos
Síndrome de Munchausen Causada por Terceiro , Cuidadores/psicologia , Criança , Protocolos Clínicos , Humanos , Síndrome de Munchausen Causada por Terceiro/diagnóstico , Síndrome de Munchausen Causada por Terceiro/legislação & jurisprudência , Síndrome de Munchausen Causada por Terceiro/psicologia , Síndrome de Munchausen Causada por Terceiro/terapia , Equipe de Assistência ao Paciente , Relações Profissional-Família , Psicoterapia/métodosRESUMO
OBJECTIVES: To review the use of psychiatric medications in the treatment of pruritus. METHODS: A literature review was conducted using the key words pruritus, psychiatric, and treatment. RESULTS: Three categories of pruritus are described: dermatologic, systemic, and psychogenic. Peripheral and central nervous system mechanisms of pruritus are reviewed. Conventional dermatologic treatments for pruritus are contrasted with some of the common psychopharmacologic treatment modalities that include anxiolytic, antidepressant, and antipsychotic agents. A treatment algorithm is offered to help guide the treatment of patients with pruritus. CONCLUSIONS: Psychiatric medications have been used successfully in the treatment of pruritus that is associated with both psychocutaneous and systemic disorders, which are resistant to conventional treatment.