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- W4292121178 abstract "<h3>Aims</h3> Fabricated Illness Induction (FII)/Perplexing Presentations (PP) is a complex and rare presentation with devastating consequences if unrecognized. The Royal College of Paediatrics and Child Health (RCPCH) recently published guidelines on how clinicians can identify and subsequently manage cases of suspected FII/PP in March 2021.<sup>1</sup> This guidance identified a number of alerting signs in the child and parent and outlined an extensive pathway of investigation and suggested management. <h3>Objective</h3> The purpose of this trust-wide audit was to assess compliance with national guidelines and to more importantly investigate if these guidelines have helped to identify cases of FII/PP. <h3>Methods</h3> Using a retrospective analysis, the audit identified 4 cases within the time period of March 2021 to September 2021. Criteria for inclusion was any child with suspected FII/PP who was escalated to the Paediatric Team. <h3>Results</h3> The results of this study have shown that cases of FII/PP were positively identified by following the new guidelines. Additionally, the audit showed that in all cases Children’s Social Care were involved and their feedback sought. All safeguarding concerns were acknowledged and children were placed in the relevant category of the Child Protection Plan. Of the cases that were escalated due to concerns of FII/PP, 75% of cases were identified as FII. Five alerting signs were seen in 100% of confirmed cases (symptoms and signs not being observed independently, symptoms and signs not consistent with condition, exam and investigations not explaining symptoms or signs, insistence on more clinically unwarranted investigations, referrals, treatment and repeated presentations to health services). Of note, is that all cases of FII/PP had more than three presenting complaints, one of which was always mental health. Popular co-presenting complaints were respiratory and neurological symptoms (figure 1). <h3>Conclusion</h3> In conclusion, national guidelines have allowed for investigation for suspected FII/PP cases and yielded a diagnosis in the majority of cases studied. While not all alerting signs were seen in each case, it is interesting to note the shared alerting signs and presenting complaints seen in all confirmed cases. Deeper investigation is warranted to look further into these findings. Given the rarity of this problem a multi-centre audit would be essential to reveal overarching trends and to assess the prevalence of FII/PP." @default.
- W4292121178 created "2022-08-17" @default.
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- W4292121178 date "2022-08-01" @default.
- W4292121178 modified "2023-09-26" @default.
- W4292121178 title "943 Perplexing puzzles: are national guidelines helping us to solve the puzzle of Fabricated Illness Induction (FII)/Perplexing Presentations (PP)?" @default.
- W4292121178 doi "https://doi.org/10.1136/archdischild-2022-rcpch.472" @default.
- W4292121178 hasPublicationYear "2022" @default.
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