Factitious disorder imposed on another
A caregiver fabricates or induces illness in another for attention.
Factitious disorder imposed on another (FDIA) is a condition in which a caregiver creates the appearance of health problems in another person, typically the caregiver's child, but occasionally an adult partner. The abuser may alter test samples, injure the victim, falsify diagnoses, or use contrived photographs or videos to convince others of underlying health conditions. The behavior is generally thought to be motivated by a desire for sympathy or attention from other people, and permanent injury or death of the victim can occur.
- First named
- Munchausen syndrome by proxy (1977)
- Also known as
- Fabricated or induced illness by carers (FII), medical child abuse
- Typical victim
- Caregiver's child (occasionally adult partner)
- Typical perpetrator
- Mother (more than 90% of cases)
- Prevalence
- Relatively rare, generally higher among women
- Prognosis for caregiver
- Poor
Lore & Background
The condition was first named 'Munchausen syndrome by proxy' in 1977 by British pediatrician Roy Meadow. The causes are generally unknown, but many believe it is associated with the caregiver having experienced traumatic events during childhood, such as parental neglect, emotional deprivation, psychological abuse, physical abuse, sexual abuse, or severe bullying. The primary motive is believed to be a desire for attention and sympathy, often with an underlying inclination to lie and manipulate others, including health professionals. Financial gain is also a motivating factor in some individuals.
Reader's Guide
Factitious disorder imposed on another represents a significant challenge in medical and legal contexts because health care providers can be manipulated into enabling the abuse, a phenomenon known as iatrogenic harm. The diagnosis is assigned to the perpetrator, while the victim may be assigned an abuse diagnosis. Management often requires removing the affected child and placing them in custody of other family members or foster care. Psychotherapy is assumed to be highly effective for those who admit they have a problem and engage in treatment, but unlikely to be effective for those lacking awareness or refusing treatment. The prevalence is unknown but appears relatively rare, with more than 90% of cases involving the mother. The prognosis for the caregiver is poor, though there is a burgeoning literature on possible effective therapy. Some aspects of FDIA may represent criminal behavior.
Did You Know?
- The most frequently reported problems in FDIA cases include apnea (26.8%), anorexia or feeding problems (24.6%), diarrhea (20%), and seizures (17.5%).
- More than 90% of cases of FDIA involve a person's mother.
- The victim is typically the caregiver's child, but is occasionally an adult partner.
More in Psychopathological syndromes 1-24
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