Factitious disorder imposed on another (FDIA) | |
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Other names |
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Specialty | Psychiatry |
Symptoms | Variable[1] |
Causes | Unknown[2] |
Risk factors | Complications of pregnancy, caregiver who was abused as a child or has factitious disorder imposed on self[3] |
Diagnostic method | Removing the child from the caregiver results in improvement, video surveillance without the knowledge of the caregiver[4] |
Differential diagnosis | Medical disorder, other forms of child abuse, delusional disorder[5] |
Treatment | Removal of the child, therapy[2][4] |
Frequency | Estimated 1 to 30 occurrences per 1,000,000 children[6] |
Factitious disorder imposed on another (FDIA), also known as fabricated or induced illness by carers (FII) and first named as Munchausen syndrome by proxy (MSbP) after Munchausen syndrome, is a mental health disorder in which a caregiver creates the appearance of health problems in another person, typically their child, and sometimes (rarely) when an adult simulates an illness in another adult partner.[7][8][9] This might include altering test samples or injuring a child.[8] The caregiver or partner then presents the person as being sick or injured.[5] Permanent injury or death of the victim can occur as a result of the disorder.[8] The behaviour might be motivated by the caregiver or partner seeking sympathy or attention.
The cause of FDIA is unknown.[2] The primary motive may be to gain attention and manipulate physicians.[4] Risk factors for FDIA include pregnancy related complications and a mother who was abused as a child or has factitious disorder imposed on self.[3] Diagnosis of a child's caregiver is supported when removing the child from the caregiver results in improvement of symptoms or video surveillance without the knowledge of the caregiver finds concerns.[4] The victims of those affected by the disorder are considered to have been subjected to a form of physical abuse and medical neglect.[1]
Management of FDIA in the affected 'caregiver' may require putting the child in foster care.[2][4][10] It is not known how effective therapy is for FDIA; it is assumed it may work for those who admit they have a problem.[4] The prevalence of FDIA is unknown,[5] but it appears to be relatively rare.[4] More than 90% of cases involve a person's mother.[3] The prognosis for the caregiver is poor.[4] However, there is a burgeoning literature on possible courses of therapy.[3] The condition was first named as "Munchausen syndrome by proxy" in 1977 by British pediatrician Roy Meadow.[4] Some aspects of FDIA may represent criminal behavior.[5]
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was invoked but never defined (see the help page).