The epidemiology, clinical features, evaluation, and management of falsely reported or induced illness in a child (Munchausen by proxy) with a focus on recognition and care of the affected child will be reviewed here.
Factitious disorder (Munchausen syndrome) and other forms of physical child abuse and neglect are discussed separately. (See "Factitious disorder and Munchausen syndrome" and "Child neglect and emotional abuse" and "Physical abuse in children: Epidemiology and clinical manifestations" and "Physical abuse in children: Diagnostic evaluation and management" and "Child abuse: Evaluation and diagnosis of abusive head trauma in infants and children".)
The terminology used to describe this condition is confusing and somewhat controversial. We prefer falsely reported or induced illness in a child because it is descriptive regarding the type of perpetrator actions it covers and focuses on the abused child.
In caring for children in whom fabrication or induction of symptoms by a caregiver is suspected, preoccupation with terminology should not get in the way of accurately describing what happened to the child (eg, induced apnea, factitious epilepsy, parental exaggeration of asthma symptoms) [1-4]. The evaluation should focus on whether the child has been abused, the manner in which the child was abused, and whether the child or his or her siblings are at risk for harm in the future [2,5]. (See 'Diagnostic evaluation' below.)
All of the following terms have been used to describe falsely reported or induced illness in a child (Munchausen syndrome by proxy) [5-8]: