{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:48:57Z","timestamp":1791557337117,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n Fabricated or Induced Illness in Children (FIIC) is a complex form of child abuse. Harm to the child is both iatrogenic and psychological, driven by caregivers. Our aim was to characterise the clinical features and outcomes of FIIC cases in a tertiary Australian child protection unit (CPU).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Retrospective review of cases referred for concerns of FIIC over a 15\u2010year period from 1 January 2006 to 31 December 2020. Cases were excluded if they did not meet the Royal College of Paediatrics and Child Health (RCPCH) definition of FIIC or if there was inadequate information available.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Twenty\u2010two referrals fulfilled the criteria for diagnosis of FIIC, constituting 0.23% of all referrals for physical abuse and neglect. There was a 4\u2010year duration between first presentation and first concern for FIIC being raised. Indirect evidence of FII was identified in 95% of cases, and only one case had direct evidence in the form of laboratory proof of poisoning. Additional child protection concerns were identified in 36% of cases. Statutory child protection reporting was made in most cases (77%). In 65% of the total cases, the child remained with the carer, who continued to seek excessive medical care\u2014all were cases of indirect FIIC.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Children with indirect evidence of FIIC are at risk of further harm through unnecessary and extensive medical investigations. Statutory agency intervention is often required, and further research is needed to identify effective multi\u2010agency management strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jpc.70206","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T07:00:41Z","timestamp":1759906841000},"page":"1872-1878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fabricated or Induced Illness in Children: Experience of a Tertiary Australian Children's Hospital"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1900-9585","authenticated-orcid":false,"given":"Sandra","family":"Hanna","sequence":"first","affiliation":[{"name":"Child Protection Unit, Sydney Children's Hospital Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7116-2339","authenticated-orcid":false,"given":"Ben W. R.","family":"Balzer","sequence":"additional","affiliation":[{"name":"Child Protection Unit, Sydney Children's Hospital Randwick New South Wales Australia"},{"name":"School of Clinical Medicine UNSW Sydney Faculty of Medicine and Health, Discipline of Paediatrics & Child Health Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia J.","family":"Garside","sequence":"additional","affiliation":[{"name":"Child Protection Unit, Sydney Children's Hospital Randwick New South Wales Australia"},{"name":"School of Clinical Medicine UNSW Sydney Faculty of Medicine and Health, Discipline of Paediatrics & Child Health Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15663"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.75.1.57"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.2001.00651.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62183-2"},{"key":"e_1_2_9_6_1","volume-title":"Perplexing Presentations (PP)\/Fabricated or Induced Illness (FII) in Children RCPCH Guidance","author":"The Royal College of Paediatrics and Child Health","year":"2021"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2017-314319"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/car.2653"},{"key":"e_1_2_9_9_1","volume-title":"Munchausen by Proxy: Clinical and Case Management Guidance","author":"APSAC Taskforce","year":"2017"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2045"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2017.07.008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2134(03)00030-9"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0145-2134(87)90081-0"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.69.6.625"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1367493512462262"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2020.104649"},{"key":"e_1_2_9_17_1","unstructured":"H.Ryan The Mothers Accused of Poisoning Their Kids. ABC News(2022) https:\/\/www.abc.net.au\/news\/2022\u201004\u201009\/munchausens\u2010by\u2010proxy\u2010mothers\u2010poisoning\u2010their\u2010children\u2010acquitted\/100973092."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-0563"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.78.3.217"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70206","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70206","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:11:11Z","timestamp":1791378671000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/jpc.70206"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70206","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"assertion":[{"value":"2025-03-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}