Factitious disorders in children: clinical and therapeutic considerations

Abstract

There is considerable lack of awareness about child and adolescent population intentionally producing dermatological symptoms and this unique group has remained underreported. The aim: this review focuses on educating dermatologists about the pathogenesis, symptomatology and management options of factitious disorders. Materials and methods: Medline search was conducted for last two decades and articles containing words factitious disorders and dermatitis artefacta were identified. Results: Children with factitious disorders suffer from other psychiatric disorders, particularly depression and borderline personality traits. The prevalence ranges from 0.5-2%. Majority of children and adolescents who engage in self-injurious behaviors do not intend to commit suicide, instead they use their self-injurious behavior as an appeal for help or a non-verbal form of communication. Conclusions: Patients should not be confronted to explore the underlying psychological conflicts, rather gentle, non-judgmental and empathic approach be utilized for a good therapeutic rapport. High index of suspicion on provider’s part is a key to diagnosis. Along with dermatological care, psychopharmacological interventions and psychotherapeutic techniques have proven helpful in this population.