Ostfeld B M, Feldman M D
Departments of Pediatrics and Psychiatry, UMDNJ-Robert Wood Johnson Medical School, St. Peter's Medical Center, New Brunswick, New Jersey, USA.
Gen Hosp Psychiatry. 1996 Mar;18(2):113-6. doi: 10.1016/0163-8343(95)00127-1.
Factitious disorder by proxy (FDP) is a form of abuse in which a caregiver surreptitiously simulates or induces illnesses in a person for whom he or she cares. Typically, a mother is the perpetrator and at least one of her children is victimized. FDP has a high morbidity and mortality rate, and a knowledgeable health team increases the primary physician's confidence in making this difficult diagnosis. The purpose of this study was to determine the levels of awareness of FDP among mental health practitioners and their sources of information. Anonymous questionnaires were sent to 687 primary care physicians and mental health practitioners. Psychiatrists (89%) and psychologists (69%) were more aware of the disorder than were social workers (42%). Years in practice were not associated with awareness of FDP. Psychiatrists were more likely than psychologists or social workers to have had exposure through an actual case or through their professional journals. These findings were statistically significant. Awareness of FDP varies significantly among mental health professionals and may reflect the availability of information during training and in journals. Since social workers and psychologists often have earlier and broader opportunities than psychiatrists to interface with families, enhancements in training and the professional literature in these disciplines are needed if FDP is to be consistently considered and identified.
代理型人为障碍（FDP）是一种虐待形式，即照料者暗中模拟或诱发其照料对象患病。通常，母亲是施虐者，她的至少一个孩子成为受害者。FDP的发病率和死亡率很高，知识渊博的医疗团队会增强主治医生做出这一疑难诊断的信心。本研究的目的是确定心理健康从业者对FDP的认知水平及其信息来源。向687名初级保健医生和心理健康从业者发放了匿名问卷。精神科医生（89%）和心理学家（69%）比社会工作者（42%）对该障碍的认知度更高。从业年限与对FDP的认知度无关。精神科医生比心理学家或社会工作者更有可能通过实际案例或专业期刊接触到该障碍。这些发现具有统计学意义。心理健康专业人员对FDP的认知差异很大，这可能反映了培训期间和期刊中信息的可得性。由于社会工作者和心理学家通常比精神科医生有更早且更广泛的机会与家庭接触，因此如果要持续考虑和识别FDP，就需要加强这些学科的培训和专业文献。
