Factitious disorder imposed on another

Factitious disorder imposed on another (FDIA), also known as fabricated or induced illness by carers (FII) or medical child abuse, and originally named Munchausen syndrome by proxy (MSbP) after Munchausen syndrome, is a mental health disorder in which a caregiver creates the appearance of health problems in another person. The victim is typically the caregiver's child but is occasionally an adult partner. A person with FDIA may create the appearance of health issues by altering test samples, injuring the victim, falsifying diagnoses, or using contrived photographs or videos. Such "evidence" can be used to convince both the victim and others of underlying health conditions. Permanent injury (physical or psychological) or even death of the victim can occur as a result of the disorder and the caretaker's actions. The behavior is generally thought to be motivated by a desire for sympathy or attention from other people.

The causes of FDIA are generally unknown, but many physicians and mental health professionals believe that the disorder is associated with the caregiver's having experienced traumatic events during childhood (for example, parental neglect, emotional deprivation, psychological abuse, physical abuse, sexual abuse, or severe bullying). The primary motive is believed to be a desire for attention and sympathy, often with an underlying inclination to lie and manipulate others (including health professionals). Financial gain is also a motivating factor in some individuals with the disorder. Common risk factors for FDIA include pregnancy related complications, past neglect or trauma, and prior diagnosis of factitious disorder imposed on self. The victims of those affected by the disorder are considered to have been subjected to a form of trauma, physical abuse, and medical neglect.

Management of FDIA in the affected 'caregiver' may require removing the affected child and putting the child into the custody of other family members or into foster care. It is not known how effective psychotherapy is for FDIA, yet it is assumed that it is likely to be highly effective for those who are able to admit they have a problem and who are willing to engage in treatment. However, psychotherapy is unlikely to be effective for an individual who lacks awareness, is incapable of recognizing their illness, or refuses to undertake treatment. The prevalence of FDIA is unknown, but it appears to be relatively rare, and its prevalence is generally higher among women. More than 90% of cases of FDIA involve a person's mother. The prognosis for the caregiver is poor. However, there is a burgeoning literature on possible courses of effective therapy. The condition was first named as "Munchausen syndrome by proxy" in 1977 by British pediatrician Roy Meadow. Some aspects of FDIA may represent criminal behavior.