Fabricated or induced illness — structured clinical viva

Frame. This is a possible induction presentation (apnoeas only with one caregiver). Prioritise child safety and multi-agency process over syndrome labelling. Historical MSBP is imperfect because it glamorizes a psychiatric eponym and can blur child-harm evidence with caregiver motivation; modern FII/MCA/CFI and FDIA separate those frames.[1][2][6][9]

Immediate safety. Medical observation with supervised access; notify local child-protection pathways on reasonable suspicion; assess siblings; senior team coherence; no corridor confrontation.[2][7]

Assessment. Multi-source chronology, symptom–observer matrix, clarify dual-role ethics, caregiver MSE after safety, describe behaviours first.[5]

Perpetrator psychopathology. Series show predominantly female caregivers, healthcare-related occupational themes, high personality and factitious comorbidity—not a single diagnosis. Assessment informs treatability and risk, not the fact of child harm alone.[3][4]

Differential. Genuine cardiorespiratory/neurological disease; anxious parenting; malingering by proxy; FDIA. Keep organic workup open.[2][5]

Covert video. Only lawful multi-agency authorised protocols; high bar; not junior freelance recording.[2][6]

Opinion product. Questions answered: mental state, deception/motivation analysis, comorbidity, recurrence risk for contact, treatment prospects (guarded for entrenched factitious dynamics). Limitations explicit; no invented statutes; no usurping court findings.[5][8]