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Perplexing Presentations - Updated Guidance around Fabricated Illness (Feb 2021)

Monday, May 10, 2021

Since the publication of the Royal College of Paediatrics and Child Health (RCPCH) guidance on Fabricated or Induced Illness by Carers (FII) in 2009, there have been significant developments in the field. The RCPCH Child Protection Companion 2013 extended the definition of FII in 2013 by introducing the term Perplexing Presentations with new suggestions for management.

In February 2021 the Royal College of Paediatricians and Child Health (RCPCH) updated its guidance on Fabricated or Induced Illness (FII). Importantly the guidance introduces a new definition which now also includes the term ‘Perplexing Presentations'.

This new guidance provides procedures for safeguarding children who present with perplexing presentations and FII and offers practical advice for paediatricians on when and how to recognise it, how to assess risk and how to manage these types of presentations in order to obtain better outcomes for children.

This guidance presents the current view and supersedes previous RCPCH guidance on this subject.