27 August 2013

Fabricating illness can be deadly

Doctors and other health care providers need to be on the lookout for parents who fabricate an illness in their children, experts warn.


Parents sometimes fabricate an illness in children, and doctors and other health care providers need to be on the lookout for this type of child abuse, experts warn.

"It is probably more common than we realise" and often goes unrecognised, Dr Harriet MacMillan, a paediatrician and child psychiatrist at McMaster University in Hamilton, Ontario, said in a university news release.

Although the occurrence is relatively rare, the death rate for children in such cases in 6% to 9%, with similar rates of permanent injury and long-term disability, said MacMillan, who conducts family violence research.

MacMillan co-authored a paper in the September issue of the journal Pediatrics that is meant to improve doctors' understanding of this issue, which has long been referred to as Munchausen syndrome by proxy.

Doctors should be suspicious when they see a child with a persistent or recurrent illness that can't be explained, especially when their signs or symptoms don't seem believable. There is no typical fabricated illness, and a parent might bring their child in for treatment of all types of problems, including bleeding, seizures, urinary tract infections or attention-deficit/hyperactivity disorder.

"It really comes down to conducting a very careful history and physical examination, with an emphasis on communication with all health care providers who have seen the child," MacMillan said. "It's important that we are thorough in seeking comprehensive information about contact with healthcare providers, while adhering to privacy legislation."

Communication among health care providers is critical because a child could be seen in many different settings.

"This is the type of condition where it is essential for clinicians to review medical records and speak with other health care providers to have complete information in conducting their assessment," MacMillan said.

More information

The U.S. National Library of Medicine has more about Munchausen syndrome by proxy.

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