Detecting fabricated or induced illness in children

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7523.978 (Published 27 October 2005) Cite this as: BMJ 2005;331:978
  1. David M Foreman, consultant (David_Foreman@doctors.net.uk)
  1. Berkshire Mental Health NHS Trust, Bracknell RG12 1LH

    May now necessitate controversial surveillance tools

    Fabricated or induced illness, sometimes called Munchausen syndrome by proxy, occurs when a carer fabricates the impression of illness in a child, sometimes deliberately harming the child to produce signs.1 The syndrome is uncommon but is associated with mortality of around 10%.2 The increased risk of unexplained death in siblings of children identified as having fabricated illness3 shows that the syndrome may be underdetected and current methods for identifying it are underdeveloped.4 The validity of the concept of fabricated or induced illness is accepted by expert professionals but has been rejected by some medical correspondents, senior politicians, and members of the public.

    The commonest methods for inducing illness seem to be poisoning, including the misuse of prescribed medication, and suffocation (which is also …

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