Characteristics of 86 families and 142 children diagnosed with Pediatric Condition Falsification in the Netherlands 2025 Worm et al

Andy

Senior Member (Voting rights)

Abstract​

Background​

The aim of this study is to analyse cases of Pediatric Condition Falsification reported to the Child Abuse Counseling and Reporting Center (CACRC) to gain more insight into possible trends or common factors that could result in an earlier diagnosis of Pediatric Condition Falsification (PCF) and identify which information is lacking. This study is the first to use the data of PCF cases reported to the CACRC in the Netherlands.

Methods​

All CACRC-files with suspected and confirmed PCF were collected over a five-year period, from January 2008 to December 2013, two of 26 CACRCs did not deliver any files. The Medical Ethical Review Committee of the Erasmus Medical Centre, Rotterdam, decided on June 20, 2014, that informed consent could be waived (METC 2014 349). Files of 86 families, with 142 children were studied.

Results​

This study has provided several new insights: about the reporter, involvement of (medical) professionals, the absence position of the fathers, restrictions in daily functioning and recovery of the PCF-victims, and the high number of formal complaints against the CACRC. This study showed a high rate of extensive medical history and a problematic childhood of the perpetrator, in accordance with literature. Information about the child's own point of view was lacking in the files.

Discussion​

This study is the first PCF study in the Netherlands to use data from the CACRC. This study made clear that a more complete and uniform method of collecting information for the CACRC case file, incorporating the child's own point of view, has to be implemented.

Conclusion​

Besides new information concerning the reporter, fathers' position, perpetrator's history and formal complaints, this study highlighted the need for uniform questionnaires. Implementing these will lead to better data collection, potentially resulting in more knowledge about PCF and the child's own perspective. A concept questionnaire has been added as an appendix (Dutch Guideline KMdF, 2025).

Paywall
 
I am struggling to read anything this evening, but am I understanding correctly that ‘paediatric condition falsification’ is basically Munchausen syndrome by Proxy?
It's at least very similar, if not the same thing:

Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment, 2013, Pediatrics
Although caregiver-fabricated illness in a child has been widely known as Munchausen syndrome by proxy, there is ongoing discussion about alternative names, including pediatric condition falsification, factitious disorder (illness) by proxy, child abuse in the medical setting, and medical child abuse.
 
It's at least very similar, if not the same thing:

Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment, 2013, Pediatrics
From the paper snippets:
Pediatric Condition Falsification (PCF) (previously called Munchausen by proxy) is a form of child abuse in which a parent or caretaker falsifies illness in a child by fabricating or inducing symptoms and presenting the child for medical care while disclaiming knowledge of the cause of the problems.
 
Sorry this is not based on anything in the review, but given the seemingly common misattribution of paediatric ME/CFS to some form of parent/carer fabrication and/or treatment refusal, do we need an additional diagnostic category of medical denial/falsification relating to a genuine biomedical condition.

I am very wary of potentially harmful false positives in diagnoses such as paediatric falsification condition, which in ME/CFS can result in physical harm arising from inappropriate treatments in addition to the emotional distress and psychological harm as rising from such misattribution.
 
Last edited:
Here’s the full paper. It seems that many of the criteria could also apply to PAIS, especially if physicians are not familiar with ME. Quite worrying if you ask me @dave30th.
I’ve been reading about a potential miscarriage of justice in a serial killer conviction in Norway. The law is very clear that you can’t be convicted if there is any reasonable doubt about them defendant being guilty.

In criminal law, the presumption of innocence is there because we think it’s better to not convict a guilty person than to convict an innocent person.

With that in mind, I wonder what kind of rights the parents have here? These are very very serious accusations and I wonder how they try to avoid false positives? What’s the threshold of certainty before giving a diagnosis of PCF, and what are the consequences of such a diagnosis?

Edit: after reading some of the article, it’s clear that PCF is not a medical diagnosis per se in the Netherlands, it’s classified as s form of child abuse and dealt with by the child abuse authorities after reports made by anyone. Although I do wonder if it’s still in their medical records?
 
Last edited:
I would also like to propose an alternative term: Paediatric Health Falsification (PHF): when a carer or healthcare worker makes it so that it appears like the child is healthier than it is, e.g. by manipulating the child into providing untrue answers about symptoms or by themselves rating the symptoms as better than they are.

This should cover many of the gaslighting interventions by BPS proponents and some of the clinician rated outcomes..
 
Mum in the Netherlands here with a son with ME/cfs and active in advocacy for children with ME and Long Covid (IACC). I've been in recent meetings with this very CACRC (VT we call it) to address the serious ongoing issues with persecution of parents with false allegations of PCF that occur when their child in fact has a post-acute infection illness (IACC) Let's just say they are not very receptive to the data we bring to them.

Dr. Worm's mission in life is to get doctors and other professionals to act on 'alarm signals' (such as frequent visits to hospitals or medically unexplained symptoms or frequent school absence and it goes on, the list fully overlaps with IACC) sooner and to immediately report this as a case of PCF. She is also broadening the terminology so it can apply to more cases - the PCF guideline was just updated and she was a big part of that. Of course she does not bother to distinguish between PCF and IACC even though people like Dr. Rowe have already done the work for her. She believes prevalence is much higher than the general scientific consensus indicates. She works for the CACRC and has built herself up as the main expert in the NL in medical child abuse.

Out of the many ethical and methodological problems in this study, here's what stands out the most:
- The total number of cases she looked at initially was 262. In 89 cases there was suspicion of PCF but it turned out it was not the case (this proves the structural issue of false allegations!). She ended up only including the 142 'confirmed' cases of PCF - these cases were only 'confirmed' by the CACRC themselves - so huge possibility for confirmation bias here.
- 1 out of 3 families from the 'confirmed' PCF cases filed a complaint or took legal action against the CACRC for bias and inaccuracies. Conveniently the author does not know what was in those complaints.
- Children were never included in the case files, they were simply not spoken to. She also infers from the data it's almost always the mothers, mostly the single ones with a history of trauma or who are sick themselves.

If I was one of those parents falsely accused of abuse through PCF when I was dealing with an ill child, I'd be furious if now my file case (even though anonymously) is used to help Dr. Worm in her witch hunt without my consent. She calls her study a 'Groundbreaking effort in PCF research' and of course her 1st recommendation is to train all (medical) professionals in recognising red flags for PCF for early reporting and intervention.

This study is going to wreak havoc overhere in the Netherlands where CBT and GET are still the nr. 1 'safe' treatment for children with ME/cfs in the Guidelines. We need it to be shredded to pieces. Hoping David Tuller will pick this up!
 
Last edited:
I’ve been reading about a potential miscarriage of justice in a serial killer conviction in Norway. The law is very clear that you can’t be convicted if there is any reasonable doubt about them defendant being guilty.

In criminal law, the presumption of innocence is there because we think it’s better to not convict a guilty person than to convict an innocent person.

With that in mind, I wonder what kind of rights the parents have here? These are very very serious accusations and I wonder how they try to avoid false positives? What’s the threshold of certainty before giving a diagnosis of PCF, and what are the consequences of such a diagnosis?

Edit: after reading some of the article, it’s clear that PCF is not a medical diagnosis per se in the Netherlands, it’s classified as s form of child abuse and dealt with by the child abuse authorities after reports made by anyone. Although I do wonder if it’s still in their medical records?
Eventhough they state it's not a diagnosis, it's practically seen as a diagnosis of the child as it explains their symptoms - regardless of the motivation of the 'abusive' parent - and it's in the medical records. I think you make a great point - if you are accused of this type of child abuse, you are guilty until proven innocent. For some families with kids with ME it can take years to get rid of the CACRC's involvement and it psychologically persecutes them for life. Some of them move abroad. Some of them are so traumatized they could not manage to fill in the survey we put out to provide data about this structural issue in the Netherlands.
 
The total number of cases she looked at initially was 262. In 89 cases there was suspicion of PCF but it turned out it was not the case (this proves the structural issue of false allegations!). She ended up only including the 142 'confirmed' cases of PCF - these cases were only 'confirmed' by the CACRC themselves - so huge possibility for confirmation bias here.
This is so absurdly high. I do think there needs to be good, clear and effective ways to find out whether there is child abuse like this going on. However, you would think just talking to the child itself would at least be part of that...

I was also able to function fine at school. They even thought I was getting "more energetic" when I was being told to push trough more!
 
Mum in the Netherlands here with a son with ME/cfs and active in advocacy for children with ME and Long Covid (IACC). I've been in recent meetings with this very CACRC (VT we call it) to address the serious ongoing issues with persecution of parents with false allegations of PCF that occur when their child in fact has a post-acute infection illness (IACC) Let's just say they are not very receptive to the data we bring to them.

Dr. Worm's mission in life is to get doctors and other professionals to act on 'alarm signals' (such as frequent visits to hospitals or medically unexplained symptoms or frequent school absence and it goes on, the list fully overlaps with IACC) sooner and to immediately report this as a case of PCF. She is also broadening the terminology so it can apply to more cases - the PCF guideline was just updated and she was a big part of that. Of course she does not bother to distinguish between PCF and IACC even though people like Dr. Rowe have already done the work for her. She believes prevalence is much higher than the general scientific consensus indicates. She works for the CACRC and has built herself up as the main expert in the NL in medical child abuse.

Out of the many ethical and methodological problems in this study, here's what stands out the most:
- The total number of cases she looked at initially was 262. In 89 cases there was suspicion of PCF but it turned out it was not the case (this proves the structural issue of false allegations!). She ended up only including the 142 'confirmed' cases of PCF - these cases were only 'confirmed' by the CACRC themselves - so huge possibility for confirmation bias here.
- 1 out of 3 families from the 'confirmed' PCF cases filed a complaint or took legal action against the CACRC for bias and inaccuracies. Conveniently the author does not know what was in those complaints.
- Children were never included in the case files, they were simply not spoken to. She also infers from the data it's almost always the mothers, mostly the single ones with a history of trauma or who are sick themselves.

If I was one of those parents falsely accused of abuse through PCF when I was dealing with an ill child, I'd be furious if now my file case (even though anonymously) is used to help Dr. Worm in her witch hunt without my consent. She calls her study a 'Groundbreaking effort in PCF research' and of course her 1st recommendation is to train all (medical) professionals in recognising red flags for PCF for early reporting and intervention.

This study is going to wreak havoc overhere in the Netherlands where CBT and GET are still the nr. 1 'safe' treatment for children with ME/cfs in the Guidelines. We need it to be shredded to pieces. Hoping David Tuller will pick this up!
I'm sorry to hear this, it's terrible.

A question I feel needs to be asked, with no assumption or inference, is whether this confusion is deliberate. ie could it be that the actual intention is that the author knows these individuals have ME/CFS and is actually meaning to categorise those who have it under the system where they are treated the same (? I'm assuming, but there could be additional things added on) as those who are child abuse?

That's a first-step question because obviously there are plenty of reasons feeding into that and I simply want to focus on whether actually from a method standpoint that is basically what is being done

Then I guess the second-step question is whether there is 'something' which is genuinely well-expounded in whatever literature that they are trying to / might need to be aware of and whether that actually looks anything like ME/CFS.

All of these 'been off school' or 'doesn't go to social events' or behavioural supposed flags must have also always historically come with that 'justified by exceptions' caveats of 'which wasn't explained by ill health/beyond what health allowed' type thing, because kids with cancer or who have been in a car crash or who have multitude other conditions aren't all being included I assume.


I don't think it is an obligation for people to assume it is either coincidence or laziness. Given the legal impact.

And I will say that all should be aware of the risk of things like this being potentially used as a weapon ie taking the description of an illness and then just retitling it as 'induced illness' would be weaponising such powers to even write such things. And so I would expect scrutiny to be equivalent to that risk potential and always checking for it.

And the history of certain schools of thinking wanting to steal powers that they are not due regarding their mode of treatment without responsibility/accountability vs the norm in medicine where someone has responsibility for outcomes and would be themselves hauled up if they ran a clinic in certain other serious illnesses that either consistently made people worse or chose not to report long-term outcomes or tried to shirk taking responsibility for it.

And these are grown-up people who might feel whatever to the norms other adults have regarding responsibility but it doesn't mean they are exempt from it being discussed in the way it is every day and built-in for every other area, particularly where there is such serious impacts and powers involved. It's normally the opposite that the more serious it is the more oversight some expects they will need to weather and yields to that discompassionately as part of what they signed up for that they need to be showing clean hands and transparency and listening/learning at all times.

I'd imagine if I got dragged into something like this that I'd be answering that question and others like it on a daily basis from concerned people given with child protection it is absolutely always about the balance of harm from missing something vs harm from getting it wrong and undue suspicion on certain demographics basically being discrimination but at a level of impact that is incredibly serious (and so I'd expect I'd have to demonstrate I'd 'checked my bias' etc).
 
Having worked in Scotland around the time of ‘the Orkney Satanic Abuse Scandal’, I was aware of some medical staff being primed to see abuse when there was none. My experience related to such as autistic children where their atypical behaviour was misinterpreted as signalling abuse rather than reflecting the conditions that children were being assessed for.

The specific cases I am thinking of were ‘lucky’ in that they were military families without local ties and with a supportive chain of command, so that with the families’ involvement we could get them transferred to other parts of the country where there were more appropriate services. However most people have no such option.

With such as ME/CFS, the symptoms are similarly different from ‘normal’ development and in the context of current medical prejudice could even be thought of as counter intuitive. Creating situations where services are primed to see child abuse dramatically increases the chances of false accusations with such as ME/CFS, particularly if services don’t recognise the condition and/or push potentially harmful interventions.

Obviously no one would want child abuse to be missed, but any research/promotion aimed at increasing its detection should also consider what the situations are where there is a much higher risk of false positives.
 
This is so absurdly high. I do think there needs to be good, clear and effective ways to find out whether there is child abuse like this going on. However, you would think just talking to the child itself would at least be part of that...

I was also able to function fine at school. They even thought I was getting "more energetic" when I was being told to push trough more!
Exactly. Many kids with PAIS collapse later into PEM when they are home and seem to be doing fine for a while.
 
Obviously no one would want child abuse to be missed
I just can't see much overlap with actual child abuse. Child abuse is not faking a child's illness, it's abusing them. It's domestic violence, it's abject behavior. It does not manifest itself as faking an illness other than in very rare exceptions, and even then the validity of the concept is extremely flimsy at best. Absolutely more children are hit by buses each year than there are genuine cases of this.

What I see happening here is abusing a fake moral panic over "won't somebody think of the children?" from people who don't believe in chronic illness, and just like most of the concepts of psychosomatic ideology were built on it, they are building the rationalization for their failures by finding anything and anyone to blame but themselves. Well, not quite building as this is already the case, so much as expanding, because a system built on lies must always keep lying.

Which itself is psychologically disturbing behavior, but that's the downside of power without responsibility: failure, but a lot worse.
 
I have been watching snippets of the Long Covid kids videos from the English Long Covid Inquiry.

My gut feeling is that from these there is material that is relevant to this - I know that is Long Covid vs ME/CFS but it is more about the idea that there was a policy of not acknowledging covid could cause harm to children and the gaslighting that followed all potentially being seen as important 'to protect children [psychologically]' including not providing diagnoses (or labels as they apparently called them)

SO the question people are noting about 'child abuse vs harm' vs of course it being only potential harms perceived in the delusion of certain people or even worse having to be collateral damage due to policies that people want to implement seems very pertinent.

I'm not convinced from this that the processes that would theoretically only supposed to have powers to protect the children who are the subject of them are necessarily being used in this way (and instead are being influenced by 'magical medical propaganda' justified based on the beliefs or sales pitch of some that admitting something exists would apparently create another 'anxiety' for populations they wrongly believe are subject to hypochondria etc). And I can't put it together yet but this seems to be trying to conflate the two (suggesting those who actually have the illness are also instead those who have a fear of the illness that they want to pretend doesn't exist).

Other than manifestos with little proper evidence/research that is science-based rather than individuals' opinions and arguments based on their own force of thoughts about 'others' etc have they made any good case of drawing a line between any of these symptoms/illnesses and supposed harm or whatnot?

The stats from when that ENglish person looked into FII accusations quite recently (this year?) and what % were found to have been dropped or eventually couldn't be upheld seem to indicate that there isn't yet, for some unexplained reason, proper monitoring to ensure that problematic definitions are being brought to account to stop resources being wasted and trauma and other harm from being caused.

Surely someone should have to provide decent evidence of there being some strong cases as to why a certain definition should be submitted into this sort of system. Which cases are these even based on?
 
- The total number of cases she looked at initially was 262. In 89 cases there was suspicion of PCF but it turned out it was not the case (this proves the structural issue of false allegations!). She ended up only including the 142 'confirmed' cases of PCF - these cases were only 'confirmed' by the CACRC themselves - so huge possibility for confirmation bias here.

I'm confused about the numbers in this paper. The say there were three categories--cases of PCF suspected by the reporter but apparently not confirmed by CACRC (262 cases); suspected by the reporter AND confirmed by CACRC (147); and then a third category of confirmed PCF by the CACRC but for which it is unknown whether the reporter suspected it. But then the title says the study is of 142 people. Has anyone found the place where they explain all this?
 
Back
Top Bottom