Forensic Assessment of Illness Falsification, Munchausen by Proxy, and Factitious Disorder, NOS

Sanders, Mary J.; Bursch, Brenda

doi:10.1177/1077559502007002003

Cited by 38 publications

(24 citation statements)

References 24 publications

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“…33,34 Although such indicators are useful in raising awareness about the possibility of fabricated illness among children of otherwise apparently caring families, such features are quite nonspecific and should not be used to make the diagnosis. 35 These characteristics overlap considerably with those of caregivers who are advocates for their children with genuine illnesses, and some parents who fabricate illness in their children do not show such features. 35 It is important to underscore that there is no consistent psychological presentation or psychiatric diagnosis among caregivers who have fabricated illness in a child.…”

Section: Epidemiologymentioning

confidence: 99%

“…35 These characteristics overlap considerably with those of caregivers who are advocates for their children with genuine illnesses, and some parents who fabricate illness in their children do not show such features. 35 It is important to underscore that there is no consistent psychological presentation or psychiatric diagnosis among caregivers who have fabricated illness in a child. 36 Children who are victims of fabricated illness can suffer significant morbidity and mortality.…”

Section: Epidemiologymentioning

confidence: 99%

“…41,42 A complete review of the medical record, although potentially daunting, is imperative. 35 Because medical records are generally extensive and usually involve multiple medical sites, identification of the condition as fabricated may be missed if the complete medical records are not reviewed. The complete medical record may not be readily available if care has been sought at different clinical settings.…”

Section: If So Who Is Instigating the Evaluations And Treatment?mentioning

confidence: 99%

“…The veracity of the claims made by the caregiver can then be assessed for each symptom and sign. 35 An important overall issue to consider is whether the medical history provided by the caregiver matches the history in the medical record and whether the diagnosis reported by the caregiver matches the diagnosis made by the physician. Because fabricating caregivers can misrepresent medical information provided by various medical professionals, it is helpful to have all involved physicians conference and develop a consensus management plan.…”

Section: If So Who Is Instigating the Evaluations And Treatment?mentioning

confidence: 99%

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Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment

Flaherty¹,

MacMillan²

2013

Pediatrics

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Caregiver-fabricated illness in a child is a form of child maltreatment caused by a caregiver who falsifies and/or induces a child’s illness, leading to unnecessary and potentially harmful medical investigations and/or treatment. This condition can result in significant morbidity and mortality. Although caregiver-fabricated illness in a child has been widely known as Munchausen syndrome by proxy, there is ongoing discussion about alternative names, including pediatric condition falsification, factitious disorder (illness) by proxy, child abuse in the medical setting, and medical child abuse. Because it is a relatively uncommon form of maltreatment, pediatricians need to have a high index of suspicion when faced with a persistent or recurrent illness that cannot be explained and that results in multiple medical procedures or when there are discrepancies between the history, physical examination, and health of a child. This report updates the previous clinical report “Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in the Medical Setting.” The authors discuss the need to agree on appropriate terminology, provide an update on published reports of new manifestations of fabricated medical conditions, and discuss approaches to assessment, diagnosis, and management, including how best to protect the child from further harm.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: If So Who Is Instigating the Evaluations And Treatment?mentioning

confidence: 99%

Section: If So Who Is Instigating the Evaluations And Treatment?mentioning

confidence: 99%

See 2 more Smart Citations

Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment

Flaherty¹,

MacMillan²

2013

Pediatrics

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“…Diagnosis of PCF is difficult and usually does not depend on a single event or test but on the entire weight of implausibility of medical events [16,18]. Unusual diseases are suspected.…”

Section: Discussionmentioning

confidence: 99%

Renal and urologic manifestations of pediatric condition falsification/Munchausen by proxy

Feldman

Grady

et al. 2007

Pediatr Nephrol

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Renal and urologic problems in pediatric condition falsification (PCF)/Munchausen by proxy (MBP) can pose frustrating diagnostic and management problems. Five previously unreported victims of PCF/MBP are described. Symptoms included artifactual hematuria, recalcitrant urinary infections, dysfunctional voiding, perineal irritation, glucosuria, and "nutcracker syndrome", in addition to alleged sexual abuse. Falsifications included false or exaggerated history, specimen contamination, and induced illness. Caretakers also intentionally withheld appropriately prescribed treatment. Children underwent invasive diagnostic and surgical procedures because of the falsifications. They developed iatrogenic complications as well as behavioral problems stemming from their abuse. A PCF/MBP database was started in 1995 and includes the characteristics of 135 PCF/MBP victims examined by the first author between 1974 and 2006. Analysis of the database revealed that 25% of the children had renal or urologic issues. They were the presenting/primary issue for five. Diagnosis of PCF/MBP was delayed an average of 4.5 years from symptom onset. Almost all patients were victimized by their mothers, and maternal health falsification and somatization were common. Thirty-one of 34 children had siblings who were also victimized, six of whom died. In conclusion, falsifications of childhood renal and urologic illness are relatively uncommon; however, the deceits are prolonged and tortuous. Early recognition and intervention might limit the harm.

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References

2011

Handbook of Child and Adolescent Drug and Substance Abuse

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Forensic Assessment of Illness Falsification, Munchausen by Proxy, and Factitious Disorder, NOS

Cited by 38 publications

References 24 publications

Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment

Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment

Renal and urologic manifestations of pediatric condition falsification/Munchausen by proxy

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