Symposium: safeguarding childrenRecognising factitious and induced illness in children

Whilst it is unusual for carers to deliberately make a child ill, misrepresenting symptoms and even falsifying signs of disease is more common. The recognition that fabricated or induced illness (FII) is occurring usually emerges over time. It is rarely if ever a single event but rather an evolving pattern. Children of both sexes and all ages can be harmed in this way however, younger children and those who have had previous significant medical conditions appear to be more vulnerable. Whilst carers might have emotional and mental health needs seeking to understand their psychopathology may detract from addressing the impact on the child. In order to protect children from harm it is important for paediatricians to be aware of this condition and be alert to warning signs seen in clinical practice. This article aims to give an overview of FII and describes some clinical cases and the red flags that can prevent cycles of over investigation and potential harm to children.