FACTITIOUS DISORDER IMPOSED ON ANOTHER (FDIA)
Introduction
Factitious disorder imposed on another (FDIA), or also known as Munchausen syndrome by proxy (MSbP), is a rare psychiatric condition, in which a person fakes a serious illness to another person, usually their child, and requests medical treatment to their child, normally to gain attention, for the principle purpose of achieving emotional gratification. Someone with FDIA will go to great lengths to make it seem like his or her child is very sick. From tampering with test results, to lying and causing grievous harm to their child that they are caring for — nothing is off-limits.
And why would someone do this? The main motivator behind FDIA is often a concrete gain in attention from others. Whether it is from family, neighbours, or even on public at large. These peoples initially and sometimes chronically will make their child to become the responsibility of medical clinics and hospitals. Nevertheless, the disorder is a mental problem, and more complex than simple dishonest simulation of symptoms, and is associated with severe emotional difficulties. The presence of this disorder also may indicate a criminal behaviour.
Symptoms
The symptoms can be emotional or physical. If a child has repeated and multiple illnesses, if the symptoms only occur when the parent is present, and if the parent seems to know a lot about medicine, despite not having previous training in the field of health care, these could be signs of FDIA. While the child is in the hospital, the parent may stay with them all the time and attend to them well, but they may appear less concerned about the child’s well-being than the health care professionals do. The parent also tends not to be involved in the care of the child. The parent may talk to the medical team a lot and try to develop a friendly relationship, but if challenged, they may become aggressive, confrontational, and possibly abusive.
The parent may be keen for the child to undergo tests that most parents would only agree to if absolutely necessary. They may encourage doctors to perform tests and procedures that are painful for the child. Documents or other sources may indicate that the mother has changed doctors frequently, or has visited different hospitals for her child’s treatment.
Treatment
Treatment involves two patients, the parent and the child. The parent will receive intensive psychotherapy and family therapy. Psychotherapy will focus on why the parent decided to fake or induce symptoms and illness in the child, and then look for ways to resolve the problem. Family therapy looks at family tensions and parenting skills, and will seek to restore the relationship between the child and the caregiver. The goal of therapy for FDIA is to help the person identify the thoughts and feelings that are contributing to the behaviour, and to learn to form relationships that are not associated with being ill.
Successful treatment of people with FDIA is difficult because those with the disorder often deny there is a problem. In addition, treatment success is dependent on catching the person in the act or the person telling the truth. People with FDIA tend to be such accomplished liars that they begin to have trouble telling fact from fiction.
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