Epidemiology

The prevalence of MBP is difficult to assess given the convincing deception that is central to the disorder. However, one careful, conservative British study estimated that the combined annual incidence of MBP in the form of nonaccidental poisoning and nonaccidental suffocation was at least 2.8 cases per 100,000 in children under age 1 year (Kin-scherff and Ayoub 2000). Based on these estimates, approximately 200 new cases develop in the United States every year, with poisoning and suffocatory abuse as the primary forms of abuse. Additionally, the literature suggests that as many as 1% of asthma clinic attendees (Godding and Kruth 1991) and 5% of allergy clinic patients (Warner and Hathaway 1984) are victims of falsification.

Repeated false allegations of sexual abuse and psychiatric presentations (Schreier 1997a, 1997b), as well as educational MBP cases presenting in school settings (Ayoub et al. 2002b), have also been described. In his book Playing Sick? Marc Feldman (2004) estimated that 1,200 new cases of MBP are reported in the United States every year. Documented cases have been described from over 30 countries around the world. Given the wide spectrum of pediatric conditions that have been known to be feigned, the problem is far from rare. Furthermore, experts now agree that many MBP cases are likely to go undetected because of the covert nature of their presentation and the striking ability of the perpetrators to fool those around them.

Permanent injury or death has been documented in over 13% of MBP cases reported in the literature (Ayoub 2006; Sheridan 2003). Among those children who died due to this form of abuse, 25% of their siblings had also died, with over one-half of them having had similar and/or suspicious symptoms (Sheridan 2003).

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