Pediatric Condition Falsification With No Factitious Disorder by Proxy

Several conditions involve parent or caregiver abuse by pediatric condition falsification (PCF) but do not involve FDP. Although the consequences of some of these other conditions may be equally as grave as those of FDP, they should be distinguished from FDP because the interventions needed to protect the child and the course of treatment are quite different. The following are some of the more common situations of PCF that are not FDP:

1. Parents falsely report abuse of their children for the primary purpose of obtaining custody or of harming their spouse or partner.

2. Parents keep children home from school with illness excuses because they need to keep the children dependent and at home, but not necessarily ill. In these situations, the child is not an object to help project the appearance of a nurturing role but rather the primary object of an enmeshed parent-child relationship in which the child is parentified. Parents do not go to lengths to have the child appear ill at home or use the child's condition as a means of attention-getting from other adults.

3. Parents who are overwhelmed and seeking assistance in caring for their children may blatantly falsify symptoms, typically on one or two occasions (Libow and Schreier 1986). These parents are usually not good at deception and are relieved when given support to allay their fears about their children.

4. A very small group of parents are psychotic, and their delusions include beliefs that their children are ill. Identification of overt psychosis is a requirement in this situation.

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