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Child and adolescent illness falsification
1Department of Psychiatry, Children's Hospital Oakland, Oakland, California 94609, USA. jlibow@mail.cho.org
Pediatrics
|February 2, 2000
Summary
Children may intentionally falsify symptoms of illness, presenting as somatizing disorders. Early identification of these cases is crucial for intervention and preventing adult factitious disorders.
Area of Science:
- Pediatric Psychology
- Child Psychiatry
- Medical Ethics
Background:
- Factitious illness in children, where individuals feign or induce symptoms, is a complex phenomenon.
- Understanding its relationship to somatizing disorders and factitious disorder by proxy is essential for accurate diagnosis and treatment.
Purpose of the Study:
- To review existing literature on factitious illness in children and adolescents.
- To clarify the connection between childhood factitious illness, somatizing disorders, and factitious disorder by proxy.
Main Methods:
- A systematic literature review of cases involving children under 18 who intentionally falsified illness symptoms.
- Exclusion criteria included parental involvement, clear motives, adult onset, and foreign language publications.
- Data extracted included age, gender, symptoms, duration, and outcomes.
Main Results:
- Forty-two cases were identified, with a mean age of 13.9 years; 71% were female.
- Commonly falsified conditions included fevers, ketoacidosis, purpura, and infections, with deception lasting a mean of 16 months.
- Children often admitted deception upon confrontation, with some showing positive outcomes; behavioral similarities to adult factitious disorder were noted.
Conclusions:
- Childhood medical condition fabrication may be misdiagnosed as somatization or go undetected.
- Investigating these cases can aid in identifying early signs of Munchausen by proxy or parental coaching.
- Improved understanding and identification can prevent the development of chronic adult factitious disorders.