The experience of 12 children with atypical psychosomatic illness who presented considerable diagnostic difficulties is described. All patients were admitted to the hospital, and using a team approach, it was possible to make a confident diagnosis. No organic disease was identified, and a psychosomatic diagnosis was made. In general, atypical symptoms and signs, false-positive investigations, and differing medical opinion had compounded the diagnostic difficulties. The value of the observations made by ward staff of the childrens' symptoms and behavior is stressed.
Get full access to this article
View all access options for this article.
References
1.
Apley J., McKeith R., Meadow R.The Child and His Symptoms. 3rd Ed. London: Blackwell, 1978.
2.
Graham P.Psychosomatic Relationships in Child Psychiatry. In: Rutter M, Hersov L, eds. Child Psychiatry—Modern Approaches. Oxford: Blackwell, 1977.
3.
Minuchin S., Fishman HCThe psychosomatic family in child psychiatry. J Am Acad Child Psych1979;18:79-90.
4.
Balint M.The Doctor, his Patient and the Illness. London : Pitman Medical, 1968.
5.
Herzog D., Harper G.Unexplained disability—diagnostic dilemmas and principles of management . Clin Ped1981;20: 761-8.
6.
Meadow R.Munchhausen syndrome by proxy. Arch Dis Child1982;57:92-8.
7.
Bingley L., Leonard J., Hensman S., et al. The comprehensive management of children on a paediatric ward—a family approach. Arch Dis Child1980;55:551-61.
8.
Sack WHMaking the "second diagnosis."Clin Ped1978 ;17: 548-50.
