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Factitious Disorder Imposed On Another Is Often Characterized By
Factitious disorder imposed on another (FDIA) is a mental illness. It causes a person to fabricate illness in a dependent, leading to the dependent receiving unnecessary medical treatment. The person does not do this for financial gain.FDIA was once called Munchausen syndrome by proxy, and it is a severe form of abuse. The dependent who receives the unnecessary medical treatment dies as a result in 6–10% of recognized cases. The relationship is most likely to involve a mother and child, and FDIA usually stems from a maladaptive disorder or a need for attention.Another type of factitious disorder is factitious disorder imposed on self (FDIS). A person with FDIS fabricates signs or symptoms of an illness in themselves.Share on PinterestA person with FDIA may invent signs and symptoms in a person they care for.FDIA is a mental health issue. A parent or caregiver with FDIA seeks medical care for a dependent person who does not need it. In more than 90% of cases, the person with FDIA is the child’s mother. The dependent is usually a child under 6 years of age, but they may be an older teen or a vulnerable adult of any age. The caregiver benefits by receiving praise for their devotion and by developing relationships with doctors and other healthcare workers.Experts describe FDIA as “relatively rare” but often misdiagnosed. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) report that around 1% of people in hospitals may meet criteria of a factitious disorder. A person with FDIA often has a history of mental health issues. A doctor may suspect FDIA if a parent or caregiver repeatedly seeks medical treatment for a child or another dependent who has unexplained symptoms. Below, find indications of FDIA.In the caregiver:describing the illness in a way that does not match the doctor’s observationsgiving vague and inconsistent information about the dependent’s medical historyaccepting risky interventions without concernshowing medical knowledge despite having no medical trainingrepeatedly requesting further actionseeking the attention and approval of healthcare workershaving a history of mental health problemshaving a lack of social network or familyAround 10–25% of people with FDIA also induce symptoms in themselves. In the dependent:showing atypical signs of a health conditionhaving several illnesseshaving normal test resultsnot responding to treatmentexperiencing symptoms only when the caregiver is presentundergoing repeated hospitalizations and surgeryhaving complications or new symptoms after a negative test resulthaving few or no visitors and only one caregiver presentWhen a person with FDIA is responsible for symptoms or illnesses, these tend to include:seizuresheadachesasthmafood allergiesgastrointestinal problemsneurological disordersweight lossapneainfections and feversbleedingkidney problemsurological problemsTo avoid detection, the caregiver may change doctors frequently or take the dependent to various hospitals for treatment.A person with FDIA may fabricate or induce an illness in various ways. For example, they may:invent signs and symptomstamper with test resultsapply chemicals to the dependent’s skin to cause a rash or irritationuse medications, such as laxatives, insulin, or psychoactive substances to trigger symptomsinjure the dependentinject the dependent with feces to cause an abscessThe effects on the dependent can be long-lasting and include: missed school and other opportunities, due to multiple hospitalizationsphysical risk, due to unnecessary procedures and tests long-term mental health problemsThe exact causes of FDIA are unclear, but experts believe that another mental illness or a past traumatic experience can play a role.According to the DSM-5, FDIA may develop after the dependent has spent time in a hospital for a legitimate reason.Also, some people with FDIA have experienced neglect, abuse, or other trauma during childhood, such as the loss of a family member. In addition, there may be a history of unusual diseases in the person’s family or a history of relationships in which illness brought positive attention.FDIA can be hard to detect because it is relatively uncommon and because doctors can usually expect caregivers to tell the truth.The DSM-5 lists the following criteria for FDIA:falsifying signs or symptoms or inducing injury or disease in another person with the intention of deceivingpresenting another person as having signs and symptoms of an illnessreceiving no external reward, such as financial gain.having no evidence of another condition, such as one that causes delusionsThe physician will note how many times the person has displayed action consistent with FDIA. If a doctor suspects FDIA, they may invite a team of experts, including physicians, psychologists, and child protection workers, to evaluate different aspects of the case.They may also retest blood and urine samples to check for concrete indications of an illness and evidence of any added substances, such as blood in urine samples. In addition, some hospitals have used video cameras to help confirm a diagnosis.Various experts can provide treatment to the caregiver and the dependent. Treatment may involve:psychotherapy and counselingfamily therapyphysical therapyFor the caregiverPsychotherapy can help the caregiver identify the reasons for their actions and how to resolve the problem. This may involve learning to form relationships that are not associated with illness.Family therapy looks at family tensions and parenting skills and seeks to promote a healthy relationship between the child and the caregiver.Effective treatment is usually possible once a person acknowledges that the problem exists. Treatment can be difficult if the person denies that they have FDIA.For the dependentA team will work with the dependent, who is usually a child, to restore their mental and physical health. In extreme cases, the child must learn to live with vision loss, impaired mobility, brain damage, or similar challenges.They may benefit from long-term counseling to deal with anxiety, trauma, and stress. They may also need to learn to form and maintain healthy relationships that do not involve being ill.Other challenges may include catching up on missed schooling, developing social skills, and restoring other aspects of a child’s usual routine. Experts suggest that the long-term outlook depends on how severe the damage is and how long it has taken doctors to identify FDIA.Some people need lifelong treatment for mental health issues and support for physical challenges.Experts also call upon doctors to be aware of the red flags, so that diagnosis can happen as early as possible.Online forums can also provide support for survivors of abuse associated with FDIA.
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