Pathophysiology Symptoms Diagnosis

• 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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