Clinical features of the index child, siblings and father
| Case | Clinical presentation and cause1-151 | Siblings | Father |
|---|---|---|---|
| 1 | Boy, living. Recurrent apnoea with near-miss death episodes from age 3 weeks to 3 months. False history and smothering | One brother—died suddenly at age 6 months having had similar history of recurrent apnoea | Munchausen syndrome since age 19 |
| 2 | Boy, living. Recurrent apnoea age 1 to 4 months. Unexplained haematemeses. Failure to thrive. False history and smothering | One sister—died aged 16 months after 4 month history of recurrent apnoea | Somatising disorder—presented mainly to family and employers since age 17. Minor fraud and much fabrication |
| 3 | Boy. Died age 21 months following history of recurrent apnoea since age 2 weeks; also haematemeses, rectal bleeding, and ingestion of unusual foreign bodies.False history, smothering, and physical abuse | Two elder siblings had fictitious epilepsy and were receiving inappropriate anticonvulsant treatment | Munchausen syndrome since age 14 |
| 4 | Girl. Died age 6 months following 3 months history of recurrent apnoea. False illness and smothering | None | Munchausen syndrome since age 16 |
| 5 | Newborn boy. Concerns about deaths of siblings. False history and smothering (of siblings) | One sister died age 4 months following bouts of recurrent apnoea from age 5 weeks. One brother died age 4 months following history of recurrent apnoea from day 4; also haematemeses | Somatising disorder since age 21 |
| 6 | Boy, living. Recurrent apnoea age 4 to 7 months. Unexplained fractures of femur and ribs. False history, smothering, and physical abuse | None | Fantastic story teller, but only a few unexplained illnesses |
| 7 | Boy, living. Recurrent apnoea age 2 weeks to 6 months. Haematemeses.False history and smothering | None | Mild somatising disorder |
| 8 | Girl. Died age 6 months following one previous episode of apnoea. Failure to thrive. Unexplained fractures. False history, smothering, physical abuse and neglect | None | No unusual medication or psychological features |
| 9 | Newborn girl. Concerns about deaths of three previous siblings. False history and smothering (of siblings) | Unexplained deaths of two boys and one girl at ages 3 months, 5 months, and 16 months. The deaths were preceded by concerns about care | Record of criminal convictions. No unusual medical features |
| 10 | Girl, living. Recurrent illnesses from 1 to 5 months, at which age she had marked hypernatraemia and high urine sodium. False history and salt (NaCl) poisoning | None | Mild somatising disorder |
| 11 | Boy, living. Recurrent unexplained illnesses age 1 week to 13 months when he had acute hepatic failure. Investigation revealed high blood levels of warfarin, paracetamol, and caffeine. False history and repetitive poisoning | One sister age 6 years—well | Munchausen syndrome since age 22 |
| 12 | Boy, living, age 3 years. Pains, haematemesis, and haematuria. False history and fabrication of samples | One healthy brother | Munchausen syndrome |
| 13 | Girl, living, age 4 years. “Severe epilepsy” causing her to miss regular education. Girl adopting chronic illness role. False history | One healthy brother | Unexceptional medical record. Since divorce 6 years before, father had been sole carer of the two children |
| 14 | Boy, living, age 4 years. Marked behaviour disturbance. Being investigated and treated by his father for alleged bowel disorders, allergy, and anaemia. False history, disordered perception, and physical abuse | One brother died age 10 years. One brother in custody | Somatisation disorder and self injury |
| 15 | Boy, living, age 9 years. “Uncontrollable epilepsy.” Previous genuine congenital bowel disorder and genuine seizures at time of viral meningitis at age 2. Father insisted that major seizures were still occurring and that the boy continued to need anticonvulsants. False story and disordered perception | Five healthy siblings, but social services concerns about standards of care. Allegation of sexual abuse | Mild somatisation disorder leading to invalidity benefit |
↵1-151 Italicised statements represent final clinical conclusions.