Munchausen by proxy: between excessive care and personality disorders

Abstract

This article discusses the phenomenon of Munchausen by Proxy (MPP), a condition that lies at the intersection between excessive care and personality disorders. To put it in context, MPP is characterized by the induction or simulation of symptoms in a person under the care of another, often a child by a parent, with profound ethical, psychological and social implications. The aim of this paper is to provide an in-depth understanding of MPP, exploring its origins, clinical manifestations and the associated psychological complexities. Using a literature review methodology, a systematic search was carried out in renowned academic databases, selecting relevant articles published in the last twenty years, in both Portuguese and English. The search strategy was meticulously planned to capture studies that directly addressed the core aspects of MPP, with a focus on its relationship with excessive caregiving and personality disorders. The results obtained reveal that MPP is often associated with specific personality disorders, such as borderline, histrionic and narcissistic. In addition, excessive care, often motivated by the unmet emotional needs of the caregiver, plays a central role in the manifestation of MPP. The review also highlights the importance of multidisciplinary diagnostic and intervention strategies to protect the victim and treat the caregiver.