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Fabricated or induced illness

Previously known in United Kingdom as Munchausen syndrome by proxy, the term ‘fabricated or induced illness in children’ (FII) was coined by the Royal College of Paediatrics and Child Health (RCPCH) in 2001, further refined in 2009 and reviewed in 2012–2013 to describe a spectrum of disorders where the carer, usually the mother, presents a child for medical attention having either fabricated or induced the child’s symptoms. This spectrum transcends boundaries of social class and other known deprivations.

Presentation

Males and females similarly affected
Main carer is the perpetrator (usually but not always the mother)
Usually, the child is under 5 years of age though can be older
The older age groups may seem to collude with the perpetrator
Repeated medical attention and investigations may mean medical staff unwittingly cause unintentional harm
Can result in neurological damage, illness, disability and, in some cases, death
Sequalae of emotional and psychological problems and behaviours for the affected child into adulthood
Difficulties in reaching a diagnosis or a decision on FII being the cause