Factitious Disorder Imposed on Another: A Case Report in the Context of Psychosocial Stressors

Abstract

Factitious Disorder Imposed on Another (FDIA) is a psychiatric condition classified as a form of child abuse, in which a caregiver intentionally produces or fabricates symptoms of illness in a dependent individual. First described by R. Meadow in 1977, FDIA is classified in the DSM-5 under Somatic Symptom and Related Disorders. Although rare, FDIA can lead to severe medical consequences. The concealment of symptoms by perpetrators complicates diagnosis, and victims are predominantly children. Reported mortality rates range between 6% and 9%, underscoring the importance of early diagnosis and regular follow-up. This case report describes a mother who brought her 18-month-old child to the emergency department with a complaint of hematuria; however, she was observed transferring her own blood onto the child’s diaper, resulting in mandatory reporting and a multidisciplinary evaluation that led to an FDIA diagnosis. Intrafamilial conflict, limited insight, and cognitive constraints were identified as contributing factors. Following a Family Court request, the mother’s custody suitability was evaluated, and supervised contact along with regular psychiatric follow-up was recommended. Nevertheless, during follow-up, the patient demonstrated irregular attendance, limited insight, and persistent externalization of responsibility, which impeded the effective implementation of clinical and judicial processes.