Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment

被引:69
作者
Flaherty, Emalee G.
MacMillan, Harriet L.
机构
关键词
Munchausen syndrome by proxy; pediatric condition falsification; factitious disorder by proxy; medical child abuse; child maltreatment; Child Protective Services; covert video surveillance; multidisciplinary child protection team; Munchausen syndrome; MUNCHAUSEN-BY-PROXY; COVERT VIDEO SURVEILLANCE; NONACCIDENTAL SUFFOCATION; FACTITIOUS DISORDER; FALSE ALLEGATIONS; FOLLOW-UP; ABUSE; FALSIFICATION; PSYCHOPATHOLOGY; IDENTIFICATION;
D O I
10.1542/peds.2013-2045
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Caregiver-fabricated illness in a child is a form of child maltreatment caused by a caregiver who falsifies and/or induces a child's illness, leading to unnecessary and potentially harmful medical investigations and/or treatment. This condition can result in significant morbidity and mortality. Although caregiver-fabricated illness in a child has been widely known as Munchausen syndrome by proxy, there is ongoing discussion about alternative names, including pediatric condition falsification, factitious disorder (illness) by proxy, child abuse in the medical setting, and medical child abuse. Because it is a relatively uncommon form of maltreatment, pediatricians need to have a high index of suspicion when faced with a persistent or recurrent illness that cannot be explained and that results in multiple medical procedures or when there are discrepancies between the history, physical examination, and health of a child. This report updates the previous clinical report "Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in the Medical Setting." The authors discuss the need to agree on appropriate terminology, provide an update on published reports of new manifestations of fabricated medical conditions, and discuss approaches to assessment, diagnosis, and management, including how best to protect the child from further harm.
引用
收藏
页码:590 / 597
页数:8
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