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Munchausen by Proxy: Quem e Como? Uma Revisão da Literatura. REVISTA PORTUGUESA DE PSIQUIATRIA E SAÚDE MENTAL 2023. [DOI: 10.51338/rppsm.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
A síndrome de Munchausen by proxy resulta numa forma de abuso infantil relativamente rara, que acarreta importantes consequências a curto, médio e longo prazo nas vítimas, geralmente crianças. O abusador, frequentemente a mãe da vítima, sem pretensão de ganhos secundários, exagera, fabrica, simula ou induz, de forma deliberada e persistente, sinais e sintomas na criança, levando os profissionais de saúde a acreditarem estar perante alguma patologia real, seguindo uma marcha diagnóstica infrutífera. Pouco se sabe sobre as características dos perpetradores, nomeadamente no que diz respeito à sua história pessoal, antecedentes psiquiátricos e características sociodemográficas, já que a grande maioria dos dados disponíveis na literatura incide apenas nas características das vítimas. Sendo um diagnóstico que levanta diferentes desafios, e provavelmente com prevalência subestimada, esta revisão da literatura debruça‐se sobre o perfil dos agressores, pretendendo consciencializar e auxiliar os profissionais de saúde na sua correta identificação, tão precoce quanto possível.
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Ricci L, Toussaint Y, Becker J, Najjar H, Renier A, Choukour M, Buisson A, Devos C, Epstein J, Peyrin Biroulet L, Guillemin F. Web-based and machine learning approaches for identification of patient-reported outcomes in inflammatory bowel disease. Dig Liver Dis 2022; 54:483-489. [PMID: 34588153 DOI: 10.1016/j.dld.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/03/2021] [Accepted: 09/08/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Messages from an Internet forum are raw material that emerges in a natural setting (i.e., non-induced by a research situation). AIMS The FLARE-IBD project aimed at using an innovative approach consisting of collecting messages posted by patients in an Internet forum and conducting a machine-learning study (data analysis/language processing) for developing a patient-reported outcome measuring flare in inflammatory bowel disease meeting international requirements. METHODS We used web-based and machine learning approaches, in the following steps. 1) Web-scraping to collect all available posts in an Internet forum (23 656 messages) and extracting metadata from the forum. 2) Twenty patients were randomly assigned 50 extracted messages; participants indicated whether the message corresponded or not to the flare phenomenon (labeling). If yes, participants were asked to identify excerpts from the text they considered significant flare markers (annotation). 3) The set of annotated messages underwent a vocabulary analysis. RESULTS The phenomenon of flare was circumscribed with the identification of 20 surrogate flare markers classified into five dimensions with their frequency within extracted labeled data: impact on life, symptoms, extra-intestinal manifestations, drugs and environmental factors. Web-based and machine-learning approaches met international recommendations to inform the content and structure for the development of patient-reported outcomes.
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Affiliation(s)
- Laetitia Ricci
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, F-54000 Nancy, France.
| | - Yannick Toussaint
- Laboratoire lorrain de recherche en informatique et ses applications, Université de Lorraine, Nancy, France.
| | - Justine Becker
- Ecole des mines de Nancy, Université de Lorraine, Nancy, France.
| | - Hiba Najjar
- Ecole des mines de Nancy, Université de Lorraine, Nancy, France.
| | - Alix Renier
- Ecole des mines de Nancy, Université de Lorraine, Nancy, France.
| | - Myriam Choukour
- INSERM, U1256 NGERE and gastroenterology Department, CHRU-Nancy, Université de Lorraine, Nancy, France.
| | | | | | - Jonathan Epstein
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, F-54000 Nancy, France; Université de Lorraine, APEMAC, F-54000 Nancy, France.
| | - Laurent Peyrin Biroulet
- INSERM, U1256 NGERE and gastroenterology Department, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - Francis Guillemin
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, F-54000 Nancy, France; Université de Lorraine, APEMAC, F-54000 Nancy, France.
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