While the child is hospitalized, medical professionals must monitor the caregivers visits to prevent an attempt to worsen the childs condition. In addition, in many jurisdictions, medical professionals have a duty to report such abuse to legal authorities. Diagnosis
Munchausen syndrome by proxy is a controversial term. In the World Health Organizations International Statistical Classification of Diseases, 10th Revision (ICD-10), the official diagnosis is factitious disorder (301.51 in ICD-9, F68.12 in ICD-10). Within the United States, factitious disorder imposed on another (FDIA or FDIoA) was officially recognized as a disorder in 2013, while in the United Kingdom, it is known as fabricated or induced illness by carers (FII).In DSM-5, the diagnostic manual published by the American Psychiatric Association in 2013, this disorder is listed under 300.19 Factitious disorder. This, in turn, encompasses two types:
Factitious Disorder Imposed on Self
Factitious Disorder Imposed on Another (Previously Factitious Disorder by Proxy); the diagnosis is assigned to the perpetrator; the person affected may be assigned an abuse diagnosis (e.g. child abuse).Both types include an optional specifier to identify if the observed behavior was a single episode or part of recurrent episodes. Warning signs
Warning signs of the disorder include:
A child who has one or more medical problems that do not respond to treatment or that follow an unusual course that is persistent, puzzling, and unexplained. Physical or laboratory findings that are highly unusual, discrepant with patients presentation or history, or physically or clinically impossible.
For example, 40% of participants dropped out of the trials, significantly decreasing their validity.Until 2002, sertraline was only approved for use in adults ages 18 and over; that year, it was approved by the FDA for use in treating children aged 6 or older with severe OCD. In 2003, the UK Medicines and Healthcare products Regulatory Agency issued a guidance that, apart from fluoxetine (Prozac), SSRIs are not suitable for the treatment of depression in patients under 18. However, sertraline can still be used in the UK for the treatment of OCD in children and adolescents. In 2005, the FDA added a boxed warning concerning pediatric suicidal behavior to all antidepressants, including sertraline. In 2007, labeling was again changed to add a warning regarding suicidal behavior in young adults ages 18 to 24. Society and culture
Generic availability
The US patent for Zoloft expired in 2006, and sertraline is available in generic form and is marketed under many brand names worldwide.In May 2020, the FDA placed Zoloft on the list of drugs currently facing a shortage. Other uses
Sertraline may be useful to treat murine Zaire ebolavirus (murine EBOV). The World Health Organization (WHO) considers this a promising area of research.Lass-Flörl et al., 2003 finds it significantly inhibits phospholipase B in the fungal genus Candida, reducing virulence.Sertraline is also a very effective leishmanicide. Specifically, Palit & Ali 2008 find that sertraline kills almost all promastigotes of Leishmania donovani.Sertraline is strongly antibacterial against some species. References
External links

"Sertraline". Drug Information Portal. US National Library of Medicine. "Sertraline hydrochloride". Drug Information Portal.