Child and Adolescent Illness Falsification

Abstract

Medical conditions fabricated by children may go undetected for a variety of reasons, or diagnosed as somatization. Further study of children who falsify symptoms may in some cases help identify earlier experiences of Munchausen by proxy abuse or covert parental coaching of illness falsification, and provide more effective interventions. Better understanding and identification of these children is likely to help prevent the development of more chronic adult factitious disorders.

A case of factitious disorder in a 9 year old girl

“…However, it has been reported in children as young as eight years with up to half of adults diagnosed with factitious disorder reporting symptoms since adolescence 2 . Among children, girls are over-represented, especially with increasing age 3 .…”

“…In children, common presentations have been fever, ketoacidosis, purpura and infections 3 . Case reports of falsified proteinuria, post-operative infection, asthma, HIV infection and 'Cinderella syndrome' where children falsify neglect, have been documented [4][5][6][7][8] .…”

“…Falsifications in younger children tend to be more obvious and easily identified 2 , as with our patient. A review of case reports revealed a mean duration of 16 months of feigned symptoms prior to detection, with a higher risk of being diagnosed as having somatization contributing to this delay 3 . However, in this patient, factitious disorder was identified within 2 weeks of presentation, due to the nature of the symptoms.…”

“…However, in this patient, factitious disorder was identified within 2 weeks of presentation, due to the nature of the symptoms. The same review described these children as having a fascination with health care similar to their adult counterparts 3 .…”

“…Available data suggest that risk of repetition is less if fabrications are confronted at an early age 2 . Thus, early identification and intervention is likely to help prevent these children from developing a more chronic course leading to adult factitious disorder 3 .…”