Citation

Walters IC, MacIntosh R, Blake KD. Paediatr. Child Health (1996) 2020; 25(6): 345-348.

Copyright

(Copyright © 2020, Canadian Paediatric Society, Publisher Pulsus Group)

DOI

10.1093/pch/pxz053

PMID

32963646 PMCID

Abstract

Factitious disorder imposed on another (FDIA) and malingering by proxy (MAL-BP) are two forms of underreported child maltreatment that should remain on physicians' differential. This case of a 2-year-old boy, which spans 6 years, reveals the complexity in and difficulties with diagnosis. Key features include the patient's mother using advanced medical jargon to report multiple disconnected concerns and visits to numerous providers. As a result, the patient underwent many investigations which often revealed normal findings. FDIA was suspected by the paediatrician, especially following corroboration with the child's day care and past primary health care provider. This case demonstrates the possible overlap in diagnoses, which are characterized by a lack of consistent presentation and deceitful caregivers, often complicated by true underlying illness. The authors use clinical experience and limited existing literature to empower paediatricians to confidently diagnose and report FDIA and MAL-BP to limit future harm to children.

Language: en

Keywords

Child abuse; Factitious disorders; Malingering; Munchausen syndrome by proxy