Diogenes
“ST. CYRIL AND ST. METHODIUS” UNIVERSITY OF VELIKO TARNOVO - UNIVERSITY PRESS

Historical Transition From Munchausen Syndrome to Factitious Disorder Imposed on Another: A Clinical Case


Authors:
Elena Ivanova Medical University, Sofia
Presiyan Burgov St. Cyril and St. Methodius University of Veliko Tarnovo, Bulgaria

Pages: 88-98
DOI: https://doi.org/10.54664/UNSA8477

Abstract:

Factitious Disorder Imposed on Another (FDIA) is a rare but clinically and socially significant condition in which a caregiver intentionally induces, simulates, or exaggerates symptoms in a dependent individual, most often a child. The concept has evolved from early descriptions of Munchausen syndrome to its current classification in ICD-11, reflecting clearer diagnostic criteria and emphasis on objective indicators, including discrepancies between reported and observed symptoms and their dependence on the caregiver’s presence. Evidence shows that victims are mainly children and adolescents with heterogeneous clinical presentations and associated emotional and behavioral difficulties, while perpetrators are most often women with relatively stable social status and frequent engagement with healthcare services. FDIA is associated with adverse outcomes such as iatrogenic harm, impaired psychosocial development, and institutional involvement. Early identification and coordinated multidisciplinary management, including psychological assessment, are essential to ensure child safety and minimize harm.

Keywords:

Factitious Disorder Imposed on Another (FDIA), Munchausen syndrome by proxy, child abuse, clinical diagnosis, and psychological assessment.

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