Pathophysiology Symptoms Diagnosis



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  • Pathophysiology

  • Symptoms

  • Diagnosis

  • Treatment

  • Polite applause



It’s an eponym

  • It’s an eponym

  • It’s not really a syndrome

  • It’s not really a disease

  • It’s not really a diagnosis

  • It’s medical… and psychiatric… and social

  • It’s very hard to treat

  • It’s hard to spell





What to call it?

  • What to call it?

  • Who can diagnose?

  • Where’s the threshold?

  • When to involve the authorities?



Not a single condition, but a variety of presentations along a spectrum of severity

  • Not a single condition, but a variety of presentations along a spectrum of severity

  • MBP is a dyadic diagnosis; PCF/FDP are individual diagnoses

  • Child abuse is child abuse, whatever the context

  • Evaluations have to be exhaustive

  • …and involve physicians





To remind pediatricians:

  • To remind pediatricians:

  • Children are injured by factitious illness

  • Harm often requires physician’s complicity

  • We can’t usually diagnose it alone (much less treat it), but

  • Medical input is essential to diagnosis

  • Our focus is on harm to the child





Asher, 1951: “Munchausen Syndrome”

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