RESUMO
This study examined the indicators of possible presence of Munchausen Syndrome by Proxy (MSBP) in pediatric inpatients discharged against-medical-advice (AMA), in cases transferred to another hospital, and in regular discharges. In a two-year period, there were fourteen AMA discharges and twenty-four transfer cases. These were compared to a randomly selected sample of forty-one regular discharges occurring during the same time period, matched for age, sex and pediatric service. The records were scored for the presence or absence of six MSBP characteristics, which had been developed from a review of MSBP literature. The findings indicated a suspicion for MSBP in 64 percent of the AMA cases, 8 percent of the transfer cases, and none in regular discharges. The findings suggest that AMA discharges need to be examined for the possible presence of MSBP.
Assuntos
Síndrome de Munchausen Causada por Terceiro/psicologia , Transtorno Depressivo/etiologia , Feminino , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/cirurgia , Nível de Saúde , Hospitalização , Hospitais Pediátricos , Humanos , Lactente , Tempo de Internação , Síndrome de Munchausen Causada por Terceiro/reabilitação , Alta do PacienteAssuntos
Antipsicóticos/efeitos adversos , Transtornos do Comportamento Infantil/tratamento farmacológico , Síndrome de Abstinência a Substâncias/diagnóstico , Antipsicóticos/uso terapêutico , Criança , Quimioterapia Combinada , Haloperidol/efeitos adversos , Haloperidol/uso terapêutico , Humanos , Lítio/efeitos adversos , Lítio/uso terapêutico , Masculino , Síndrome de Abstinência a Substâncias/etiologiaRESUMO
Conversion reactions in children represent a form of "body language," a plea for help in a child who has no alternative method of communicating stress. Although conversion reaction may take many forms, this report focuses on those presenting as neurologic dysfunction. The parallel evaluation and treatment of these symptoms by a child psychiatry/pediatric neurology team has demonstrated success in removing the symptom while simultaneously evaluating the underlying stress. Unnecessary medical tests have been avoided and perpetuating factors have been eliminated. Continued family treatment has emphasized health rather than disease and seems to have prevented recurrence.
Assuntos
Transtorno Conversivo/psicologia , Doenças do Sistema Nervoso/psicologia , Adolescente , Criança , Transtorno Conversivo/terapia , Terapia Familiar , Feminino , Seguimentos , Humanos , Cinésica , Masculino , Doenças do Sistema Nervoso/terapia , Exame Neurológico , Equipe de Assistência ao PacienteRESUMO
Two methods of patient intake in a child psychiatry outpatient clinic were compared. In one, appointments were made immediately upon request; in the second, completion of a parental questionnaire was required before an appointment was made. Results indicated that a commitment from the parent/guardian evidenced by completing a parent-questionnaire prior to the screening appointment 1) significantly increased the attendance rate at first appointments, and 2) increased compliance in follow-up treatment. These findings indicate the importance of improved communication between parents and clinic personnel in facilitating the treatment of children.