Characteristics, interventions, and outcomes of factitious disorder imposed on another (FDIA): a systematic review of 455 perpetrators and 469 victims

Background: Factious disorder imposed on another (FDIA) is a severe yet often undetected form of abuse and mental disorder in which a caregiver recurrently falsifies a disease in another person to obtain medical and secondary benefits. We conducted this review to summarize the characteristics of both the perpetrators and the victims, as well as the interventions and outcomes. Methods: Seven electronic databases were searched for FDIA case reports and series published from the establishment of the database to August 20, 2024. Our search yielded 314 studies covering a total sample of 455 perpetrators and 469 victims. Information extracted included demographic and clinical characteristics of perpetrators and victims, in addition to interventions and outcomes. Results: Most of the victims were children (28.36%) and adolescents (27.93%), with slightly more males (56.50%) than females (43.50%). Most perpetrators were female (92.75%), married (52.09%), literate (30.33%), employed (26.59%), and with stable economic status (20.44%). Both the victims and perpetrators had physical, psychological, and behavioral problems. The most common intervention for FDIA was medical treatment, which was received by 25.49% of perpetrators and 40.51% of victims. The most common outcomes were victims being raised by foster care or social authorities (14.50%) and perpetrators being accused of a crime (29.67%). Conclusion: Our review opens the possibility of creating international multicenter databases of abuse cases in the FDIA context, which requires a multidisciplinary and transcultural approach to include all single case reports or case series to enrich the understanding of FDIA.